340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0906
CAH321313-00 REHOBOTH MCKINLEY CHRISTIAN HOSPITAL
Print
Covered Entity Details
Entity Name
REHOBOTH MCKINLEY CHRISTIAN HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH321313-00
Entity Address
1901 RED ROCK DRIVE
GALLUP, NM 87301
Medicare Provider Number
321313
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0906
Pharmacy Address
1650WEST MALONEY AVENUE
GALLUP, NM 87301
Pharmacy Comments
Contract Details
Approval Date
2/6/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
wayne H Gillis, CEO
(505) 863-7004
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/15/2025
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