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WAL-MART PHARMACY 10-1317
DSH340023 ADVENTHEALTH HENDERSONVILLE
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Covered Entity Details
Entity Name
ADVENTHEALTH HENDERSONVILLE
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340023
Entity Address
100 HOSPITAL DRIVE
HENDERSONVILLE, NC 28792
Medicare Provider Number
340023
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1317
Pharmacy Address
125 BLEACHERY BLVD
ASHEVILLE(E), NC 28805
Pharmacy Comments
Contract Details
Approval Date
7/6/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Wendi Barber, VP FINANCE, CFO
(828) 681-2102
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/6/2017
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