340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
DSH270012 BENEFIS HOSPITALS INC.
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Covered Entity Details
Entity Name
BENEFIS HOSPITALS INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH270012
Entity Address
1101 26TH STREET SOUTH
GREAT FALLS, MT 59405
Medicare Provider Number
270012
Participating Start Date
1/1/2019
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
1/15/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Forrest Ehlinger, Chief Financial Officer
(406) 455-5479
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/15/2024
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