340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
RRC350070-00 INNOVIS HEALTH
Print
Covered Entity Details
Entity Name
INNOVIS HEALTH
Subdivision Name
Type
Rural Referral Center
340B ID
RRC350070-00
Entity Address
3000 32ND AVENUE S
FARGO, ND 58103
Medicare Provider Number
350070
Participating Start Date
4/1/2022
Last Recertification Date
9/9/2024
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
7/5/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Al Hurley, COO
(701) 364-7667
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/5/2023
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