340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
CAH131308-00 CASCADE MEDICAL CENTER
Print
Covered Entity Details
Entity Name
CASCADE MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH131308-00
Entity Address
402 Lake Cascade Parkway
CASCADE, ID 83611-0151
Medicare Provider Number
131308
Participating Start Date
4/1/2018
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
1/12/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Donnahoo, CFO
(208) 382-4285 Ext: 1100
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/12/2024
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