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WALMART PHARMACY 10-5169
CAH171349-00 Cloud County Health Center
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Covered Entity Details
Entity Name
Cloud County Health Center
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171349-00
Entity Address
155 West College Drive
Concordia, KS 66901
Medicare Provider Number
171349
Participating Start Date
4/1/2014
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
Pharmacy Comments
Contract Details
Approval Date
1/11/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ron D Harrington, CFO
(785) 243-8430
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/11/2024
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