340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
CH062780A GREAT SALT PLAINS HEALTH CENTER, INC.
Print
Covered Entity Details
Entity Name
GREAT SALT PLAINS HEALTH CENTER, INC.
Subdivision Name
GSPHC - Medford Satellite Location
Type
HRSA-Funded Health Center
340B ID
CH062780A
Entity Address
619 N Front St
Medford, OK 73759-2704
Grant Number
H80CS08744
Participating Start Date
7/1/2013
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/2/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/7/2023
Agreement registered in error
Contacts
Covered Entity Signing Official
TIM STARKEY, CEO/EXECUTIVE DIRECTOR
(580) 596-2800
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/2/2023
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