340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
CAH351308-00 NELSON COUNTY HEALTH SYSTEM-HOSPITAL
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Covered Entity Details
Entity Name
NELSON COUNTY HEALTH SYSTEM-HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH351308-00
Entity Address
200 NORTH MAIN STREET
MCVILLE, ND 58254
Medicare Provider Number
351308
Participating Start Date
7/1/2017
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/10/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Samantha Harding Harding, CEO
(701) 322-4314
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/16/2023
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