340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
CAH241323-00 Madelia Health
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Covered Entity Details
Entity Name
Madelia Health
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241323-00
Entity Address
121 DREW AVE SE
MADELIA, MN 56062
Medicare Provider Number
241323
Participating Start Date
4/1/2011
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
4/4/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Frank Walz, CEO
(507) 642-3255
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
4/4/2024
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