340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
CAH201303-00 PENOBSCOT VALLEY HOSPITAL
Print
Covered Entity Details
Entity Name
PENOBSCOT VALLEY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH201303-00
Entity Address
7 TRANSALPINE ROAD
LINCOLN, ME 04457
Medicare Provider Number
201303
Participating Start Date
4/1/2011
Last Recertification Date
8/23/2024
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
Amy Theriault, Chief Operating Officer
(207) 794-3321
Contract Pharmacy Representative
Walmart
Van Donn, Director of Contracting
(479) 277-3719
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