340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-4606
CAH161348-00 CLARKE COUNTY PUBLIC HOSPITAL
Print
Covered Entity Details
Entity Name
CLARKE COUNTY PUBLIC HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH161348-00
Entity Address
800 S FILLMORE ST
OSCEOLA, IA 50213-1694
Medicare Provider Number
161348
Participating Start Date
9/24/2010
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4606
Pharmacy Address
2400 COLLEGE DR.
OSCEOLA, IA 50213
Pharmacy Comments
Contract Details
Approval Date
10/5/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/8/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
MICHAEL THILGES, CHIEF FINANCIAL OFFICER
(641) 342-5327
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
10/5/2016
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