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WALMART PHARMACY 10-5169
DSH340120 DUPLIN GENERAL HOSPITAL, INC. D/B/A ECU HEALTH DUPLIN HOSPITAL
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Covered Entity Details
Entity Name
DUPLIN GENERAL HOSPITAL, INC. D/B/A ECU HEALTH DUPLIN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340120
Entity Address
401 NORTH MAIN STREET
KENANSVILLE, NC 28349
Medicare Provider Number
340120
Participating Start Date
7/1/2004
Last Recertification Date
9/5/2024
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
Lucinda Crawford, VP Financial Services
(910) 296-2608
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/11/2024
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