340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
CAH271347-00 Holy Rosary Healthcare dba Intermountain Health Holy Rosary Hospital
Print
Covered Entity Details
Entity Name
Holy Rosary Healthcare dba Intermountain Health Holy Rosary Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH271347-00
Entity Address
2600 Wilson Street
Miles City, MT 59301
Medicare Provider Number
271347
Participating Start Date
10/1/2011
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/19/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/7/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Pam Palagi, VP Financial Services
(406) 723-2414
Contract Pharmacy Representative
Wal-Mart
Julie Howard, 340B Program Manager
(479) 739-1973
Signed By Date
10/19/2023
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