340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
DSH050103 WHITE MEMORIAL MEDICAL CENTER, DBA Adventist Health White Memorial
Print
Covered Entity Details
Entity Name
WHITE MEMORIAL MEDICAL CENTER, DBA Adventist Health White Memorial
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050103
Entity Address
1720 EAST CESAR E CHAVEZ AVENUE
LOS ANGELES, CA 90033
Medicare Provider Number
050103
Participating Start Date
7/1/2005
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
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
Francis Christopher Owens, Finance Officer
(323) 268-5000 Ext: 14733
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/13/2023
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