340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
DSH180048 EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180048
Entity Address
217 SOUTH THIRD STREET
DANVILLE, KY 40422
Medicare Provider Number
180048
Participating Start Date
10/1/2004
Last Recertification Date
8/16/2024
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
Amanda J. Kinman, Chief Financial Officer
(859) 239-2424
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/12/2023
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