340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
CAH171381-00 Hosp Dist #1 of Dickinson
Print
Covered Entity Details
Entity Name
Hosp Dist #1 of Dickinson
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171381-00
Entity Address
511 NE 10th Street
Abilene, KS 67410
Medicare Provider Number
171381
Participating Start Date
10/1/2012
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Reginald Harold Courtois, CEO
(785) 263-6610
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/11/2023
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