340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
CAH161364-00 JEFFERSON COUNTY HEALTH CENTER
Print
Covered Entity Details
Entity Name
JEFFERSON COUNTY HEALTH CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH161364-00
Entity Address
2000 SOUTH MAIN STREET
FAIRFIELD, IA 52556
Medicare Provider Number
161364
Participating Start Date
8/24/2010
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
1/2/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BRYAN HUNGER, CEO
(641) 469-4303
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/2/2024
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