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Walmart Pharmacy 10-7611
CAH331320-00 Bassett Hospital of Schoharie County dba Cobleskill Regional Hospital
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Covered Entity Details
Entity Name
Bassett Hospital of Schoharie County dba Cobleskill Regional Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH331320-00
Entity Address
178 Grandview Drive
Cobleskill, NY 12043
Medicare Provider Number
331320
Participating Start Date
10/1/2019
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/10/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Guy DiStefano, VP of Financial Operations
(607) 547-3692
Contract Pharmacy Representative
Wal-mart
Laura Levine, Manager Contracting
(479) 204-8550
Signed By Date
10/10/2023
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