340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
CAH191318-00 Concordia Parish Hospital Service District 1 DBA Trinity Medical
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Covered Entity Details
Entity Name
Concordia Parish Hospital Service District 1 DBA Trinity Medical
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH191318-00
Entity Address
6569 Hwy 84
Ferriday, LA 71334
Medicare Provider Number
191318
Participating Start Date
10/1/2011
Last Recertification Date
8/27/2024
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
Nekeisha Smith, CEO
(318) 757-6551 Ext: 612
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/12/2023
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