340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
SCH140001-00 GRAHAM HOSPITAL ASSOCIATION
Print
Covered Entity Details
Entity Name
GRAHAM HOSPITAL ASSOCIATION
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH140001-00
Entity Address
210 W. Walnut Street
Canton, IL 61520
Medicare Provider Number
140001
Participating Start Date
7/1/2015
Last Recertification Date
8/26/2024
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
Holly Henline, VP of Ancillary Services & Corporate Compliance Officer
(309) 647-5240 Ext: 2709
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(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