340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-1033
FQHCLA419 Centerstone Health Services, Inc.
Print
Covered Entity Details
Entity Name
Centerstone Health Services, Inc.
Subdivision Name
Centerstone Health Services - Connersville
Type
Health Center Program Look-Alike
340B ID
FQHCLA419
Entity Address
390 Erie Ave
Connersville, IN 47331-3177
Grant Number
LALCS40181
Participating Start Date
4/1/2021
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1033
Pharmacy Address
1600 E TIPTON ST
SEYMOUR, IN 47274
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
Robert Siegmann, Executive Director
(812) 344-4935
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