340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
DSH230036 MyMichigan Medical Center Alpena
Print
Covered Entity Details
Entity Name
MyMichigan Medical Center Alpena
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230036
Entity Address
1501 W. CHISHOLM
ALPENA, MI 49707
Medicare Provider Number
230036
Participating Start Date
7/1/2019
Last Recertification Date
8/16/2024
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
4/12/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/24/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
michael joseph erickson, President
(989) 839-3378
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/12/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session