340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
DSH380090 BAY AREA HOSPITAL
Print
Covered Entity Details
Entity Name
BAY AREA HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH380090
Entity Address
1775 THOMPSON ROAD
COOS BAY, OR 97420-2125
Medicare Provider Number
380090
Participating Start Date
4/1/2022
Last Recertification Date
8/27/2024
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
7/10/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brian Jones Moore, President and CEO
(541) 269-8124
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/10/2023
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