340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0098
DSH190151 RICHARDSON MEDICAL CENTER
Print
Covered Entity Details
Entity Name
RICHARDSON MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190151
Entity Address
254 HWY 3048
RAYVILLE, LA 71269
Medicare Provider Number
190151
Participating Start Date
7/1/2005
Last Recertification Date
9/8/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0098
Pharmacy Address
6091 MER ROUGE RD., HWY 165
BASTROP, LA 71220
Pharmacy Comments
Contract Details
Approval Date
4/11/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/18/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Barrett, CEO
(318) 728-8389
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/11/2013
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