340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
DSH450424 Houston Methodist Baytown Hospital
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Covered Entity Details
Entity Name
Houston Methodist Baytown Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450424
Entity Address
4401 GARTH ROAD
BAYTOWN, TX 77521-2122
Medicare Provider Number
450424
Participating Start Date
4/1/2009
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/14/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Adrienne E Joseph, Vice President/COO
(281) 420-8924
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/14/2023
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