340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
CAH251308-00 PONTOTOC HEALTH SERVICES
Print
Covered Entity Details
Entity Name
PONTOTOC HEALTH SERVICES
Subdivision Name
PONTOTOC HEALTH SERVICES
Type
Critical Access Hospital
340B ID
CAH251308-00
Entity Address
176 SOUTH MAIN
PONTOTOC, MS 38863
Medicare Provider Number
251308
Participating Start Date
1/1/2015
Last Recertification Date
9/6/2024
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
4/10/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
BRUCE J. TOPPIN, GENERAL COUNSEL, PRIVACY OFFICER & COPORATE SECRETARY
(662) 377-4229
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