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WALMART PHARMACY 10-5169
DSH450236 CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance
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Covered Entity Details
Entity Name
CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450236
Entity Address
115 AIRPORT ROAD
SULPHUR SPRINGS, TX 75482
Medicare Provider Number
450236
Participating Start Date
1/1/2018
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
Contacts
Covered Entity Signing Official
Paul Harvey, CEO
(903) 439-4052
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/12/2023
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