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WALMART PHARMACY 10-5169
CAH391315-00 Elk Regional Health Center
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Covered Entity Details
Entity Name
Elk Regional Health Center
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH391315-00
Entity Address
763 Johnsonburg RD
St. Marys, PA 15857
Medicare Provider Number
391315
Participating Start Date
1/1/2017
Last Recertification Date
8/12/2024
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
4/17/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Heather B Schneider, System CFO
(814) 375-6432
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/17/2023
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