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Walmart Pharmacy 10-7611
CAH451311-00 SWEENY HOSPITAL DISTRICT
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Covered Entity Details
Entity Name
SWEENY HOSPITAL DISTRICT
Subdivision Name
SWEENY COMMUNITY HOSPITAL
Type
Critical Access Hospital
340B ID
CAH451311-00
Entity Address
305 N. MCKINNEY ST.
SWEENY, TX 77480
Medicare Provider Number
451311
Participating Start Date
9/10/2010
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
1/4/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kelly Park, CEO
(979) 548-1570 Ext: 1570
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/4/2024
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