340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
CH033180 BALTIMORE MEDICAL SYSTEM, INC.
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Covered Entity Details
Entity Name
BALTIMORE MEDICAL SYSTEM, INC.
Subdivision Name
BMS at Yard 56
Type
HRSA-Funded Health Center
340B ID
CH033180
Entity Address
5525 Eastern Avenue
Suite 301
Baltimore, MD 21224-2029
Grant Number
H80CS00800
Participating Start Date
10/1/1998
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/25/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shirley Sutton, Chief Executive Officer
(410) 558-4891
Contract Pharmacy Representative
Walmart
Van Donn, Director of Contracting 340b
(303) 261-5549
Signed By Date
10/25/2023
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