340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
CAH321300-00 SIERRA VISTA HOSPITAL
Print
Covered Entity Details
Entity Name
SIERRA VISTA HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH321300-00
Entity Address
800 EAST 9TH AVE.
TRUTH OR CONSEQUENCES, NM 87901-1961
Medicare Provider Number
321300
Participating Start Date
7/1/2018
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
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
Frank A Corcoran, CEO
(575) 743-1201
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/11/2024
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