340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
DSH190006 UNIVERSITY HOSPITAL AND CLINICS
Print
Covered Entity Details
Entity Name
UNIVERSITY HOSPITAL AND CLINICS
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190006
Entity Address
2390 W CONGRESS ST.
LAFAYETTE, LA 70506
Medicare Provider Number
190006
Participating Start Date
1/1/1998
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
1/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Glenn Dailey, CEO
(337) 261-6005
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/16/2023
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