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Walmart Pharmacy 10-7611
CAH331313-00 SCHUYLER HOSPITAL INC
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Covered Entity Details
Entity Name
SCHUYLER HOSPITAL INC
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH331313-00
Entity Address
220 STEUBEN ST
MONTOUR FALLS, NY 14865
Medicare Provider Number
331313
Participating Start Date
1/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rebecca Gould, President / CFO
(607) 535-8639 Ext: 3801
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/16/2024
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