340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
CAH241329-00 LAKEWOOD HEALTH SYSTEM
Print
Covered Entity Details
Entity Name
LAKEWOOD HEALTH SYSTEM
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241329-00
Entity Address
49725 COUNTY 83
STAPLES, MN 56479
Medicare Provider Number
241329
Participating Start Date
9/24/2010
Last Recertification Date
8/19/2024
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
10/4/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Thomas Reycraft, CFO
(218) 894-8194
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/4/2024
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