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WALMART PHARMACY 10-5169
CAH041308-00 MCGEHEE HOSPITAL INC.
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Covered Entity Details
Entity Name
MCGEHEE HOSPITAL INC.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH041308-00
Entity Address
900 South 3rd
MCGEHEE, AR 71654
Medicare Provider Number
041308
Participating Start Date
10/1/2017
Last Recertification Date
9/4/2024
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
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Terry Lee Amstutz, CEO
(870) 690-4231 Ext: 4231
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/17/2023
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