340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
CAH301309-00 MONADNOCK COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
MONADNOCK COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH301309-00
Entity Address
452 OLD STREET ROAD
PETERBOROUGH, NH 03458
Medicare Provider Number
301309
Participating Start Date
9/29/2010
Last Recertification Date
9/16/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Scheinblum, CFO
(603) 924-4699 Ext: 1738
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/13/2023
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