340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
CAH141334-00 SAINT JOSEPH MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
SAINT JOSEPH MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH141334-00
Entity Address
2 SOUTH HOSPITAL DRIVE
MURPHYSBORO, IL 62966
Medicare Provider Number
141334
Participating Start Date
9/28/2010
Last Recertification Date
9/5/2024
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
4/14/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Warren Ladner, CFO
(618) 457-5200 Ext: 67130
Contract Pharmacy Representative
Walgreens
Debra Fogg, Client Relationship Analyst
(224) 300-5128
Signed By Date
4/14/2023
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