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WAL-MART CENTRAL FILL 10-2670
CAH041313-00 OZARK HEALTH INC
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Covered Entity Details
Entity Name
OZARK HEALTH INC
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH041313-00
Entity Address
2500 HIGHWAY 65 S
CLINTON, AR 72031
Medicare Provider Number
041313
Participating Start Date
7/1/2022
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WAL-MART CENTRAL FILL 10-2670
Pharmacy Address
608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robin Corley, CFO
(501) 745-9302
Contract Pharmacy Representative
Walmart
Nick Tallman, Sr. Director, Merchandise Operations – Pharmacy
(479) 371-0417
Signed By Date
4/15/2025
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