340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2037
CAH501304-00 Grays Harbor County Public Hospital District No. 1 DBA Summit Pacific Medical Center
Print
Covered Entity Details
Entity Name
Grays Harbor County Public Hospital District No. 1 DBA Summit Pacific Medical Center
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH501304-00
Entity Address
600 East Main St
Elma, WA 98541
Medicare Provider Number
501304
Participating Start Date
1/1/2015
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2037
Pharmacy Address
909 EAST WISH KAH 6 HWY 12 + 101 EAST
ABERDEEN, WA 98520
Pharmacy Comments
Contract Details
Approval Date
10/1/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Will S. Callicoat, CFO
(360) 346-2246
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
10/1/2015
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