340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
CAH511306-00 HOSPITAL DEVELOPMENT CORPORATION DBA ROANE GENERAL HOSPITAL
Print
Covered Entity Details
Entity Name
HOSPITAL DEVELOPMENT CORPORATION DBA ROANE GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH511306-00
Entity Address
200 HOSPITAL DRIVE
SPENCER, WV 25276
Medicare Provider Number
511306
Participating Start Date
7/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/18/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DOUGLAS E. BENTZ, CEO
(304) 927-6200
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/18/2023
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