340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
SCH200050-00 MAINE COAST MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
MAINE COAST MEMORIAL HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH200050-00
Entity Address
50 UNION STREET
ELLSWORTH, ME 04605
Medicare Provider Number
200050
Participating Start Date
4/1/2020
Last Recertification Date
9/9/2024
Entity Termination Date
7/1/2025
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
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Wendy June Merchant, VP of Finance
(207) 610-2429
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/16/2024
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