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WAL-MART PHARMACY 10-5315
CAH011307-00 Medical Center Barbour
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Covered Entity Details
Entity Name
Medical Center Barbour
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH011307-00
Entity Address
820 West Washington Street
Eufaula, AL 36027
Medicare Provider Number
011307
Participating Start Date
1/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5315
Pharmacy Address
2354 COMMERCE PARK DR.
ORLANDO, FL 32819
Pharmacy Comments
Contract Details
Approval Date
10/17/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sonya Bedsole, Controller
(334) 688-7132
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/15/2024
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