340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0584
CAH181311-00 ST ELIZABETH HEALTHCARE GRANT COUNTY
Print
Covered Entity Details
Entity Name
ST ELIZABETH HEALTHCARE GRANT COUNTY
Subdivision Name
ST ELIZABETH GRANT COUNTY
Type
Critical Access Hospital
340B ID
CAH181311-00
Entity Address
238 BARNES RD
WILLIAMSTOWN, KY 41097
Medicare Provider Number
181311
Participating Start Date
10/1/2018
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0584
Pharmacy Address
20 FERGUSON BLVD.
DRY RIDGE, KY 41035
Pharmacy Comments
Contract Details
Approval Date
4/30/2012
Contract Begin Date
4/30/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2016
Contacts
Covered Entity Signing Official
GARREN COLVIN, SENIOR VICE PRESIDENT, CFO
(859) 655-1642
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/6/2012
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