340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
DSH230217 Oaklawn Hospital
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Covered Entity Details
Entity Name
Oaklawn Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230217
Entity Address
200 North Madison
Marshall, MI 49068
Medicare Provider Number
230217
Participating Start Date
10/1/2011
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Andrew James Poole, CFO
(269) 789-3936
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/13/2023
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