340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
CAH151333-00 PUTNAM COUNTY HOSPITAL
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Covered Entity Details
Entity Name
PUTNAM COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH151333-00
Entity Address
1542 S BLOOMINGTON ST
GREENCASTLE, IN 46135-2297
Medicare Provider Number
151333
Participating Start Date
8/18/2010
Last Recertification Date
8/20/2024
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
Contacts
Covered Entity Signing Official
DENNIS WEATHERFORD, CEO
(765) 301-7525 Ext: 7524
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/16/2023
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