Contract Pharmacy Details

WALMART PHARMACY 10-5169
CAH151329-00 MARGARET MARY COMMUNITY HOSPITAL, INC.

Covered Entity Details

Entity Name

MARGARET MARY COMMUNITY HOSPITAL, INC.

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH151329-00

Entity Address

321 MITCHELL AVE
BATESVILLE, IN 47006-0226

Medicare Provider Number

151329

Participating Start Date

9/28/2010

Last Recertification Date

8/27/2024

Pharmacy Details

Pharmacy Name

WALMART PHARMACY 10-5169

Pharmacy Address

2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756

Pharmacy Comments

Contract Details

Approval Date

4/15/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Brian Daeger, COO
(812) 933-5135

Contract Pharmacy Representative

Walmart
Julie Howard, 340B Program Manager
(479) 277-1498

Signed By Date

4/15/2024

340B Drug Pricing Program Database