340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2714
CAH161357-00 PALO ALTO COUNTY HOSPITAL
Print
Covered Entity Details
Entity Name
PALO ALTO COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH161357-00
Entity Address
3201 FIRST STREET
EMMETSBURG, IA 50536-2516
Medicare Provider Number
161357
Participating Start Date
9/24/2010
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2714
Pharmacy Address
500 11TH STREET, S.W.
SPENCER, IA 51301
Pharmacy Comments
Contract Details
Approval Date
1/19/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Desiree Einsweiler, ADMINISTRATOR/CEO
(712) 852-5401
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
1/19/2017
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