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WAL-MART PHARMACY 10-5315
CAH451387-00 Uvalde Memorial Hospital
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Covered Entity Details
Entity Name
Uvalde Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH451387-00
Entity Address
1025 Garner Field Road
Uvalde, TX 78801
Medicare Provider Number
451387
Participating Start Date
7/1/2017
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5315
Pharmacy Address
2354 COMMERCE PARK DR.
ORLANDO, FL 32819
Pharmacy Comments
Contract Details
Approval Date
7/14/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Terri Contreras, Chief Financial Officer
(830) 278-6251 Ext: 1283
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/14/2023
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