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WALMART PHARMACY 10-5169
CAH241327-00 SLEEPY EYE MUNICIPAL HOSPITAL
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Covered Entity Details
Entity Name
SLEEPY EYE MUNICIPAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241327-00
Entity Address
400 FOURTH AVENUE NORTHWEST
SLEEPY EYE, MN 56085
Medicare Provider Number
241327
Participating Start Date
4/1/2017
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
Pharmacy Comments
Contract Details
Approval Date
4/11/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin Sellheim, Hospital Administrator
(507) 794-3571 Ext: 3005
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/11/2023
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