340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
DSH050039 ENLOE MEDICAL CENTER
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Covered Entity Details
Entity Name
ENLOE MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050039
Entity Address
1531 ESPLANADE
CHICO, CA 95926
Medicare Provider Number
050039
Participating Start Date
1/1/2017
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
10/24/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/12/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kevin Woodward, VP/Chief Financial Officer
(530) 332-6733
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/24/2023
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