340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
CAH181322-00 CALDWELL COUNTY HOSPITAL
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Covered Entity Details
Entity Name
CALDWELL COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH181322-00
Entity Address
100 MEDICAL CENTER DRIVE
PRINCETON, KY 42445
Medicare Provider Number
181322
Participating Start Date
10/1/2018
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Harold Daniel Odegaard, CEO
(270) 365-0321
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/12/2023
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