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WAL-MART PHARMACY 10-0281
CAH041312-00 BAPTIST HEALTH MEDICAL CENTER HEBER SPRINGS
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Covered Entity Details
Entity Name
BAPTIST HEALTH MEDICAL CENTER HEBER SPRINGS
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH041312-00
Entity Address
1800 BYPASS ROAD
HEBER SPRINGS, AR 72543
Medicare Provider Number
041312
Participating Start Date
9/27/2010
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0281
Pharmacy Address
1500 HIGHWAY 25B NORTH
HEBER SPRINGS, AR 72543
Pharmacy Comments
Contract Details
Approval Date
11/29/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
EDWARD LACY, VICE PRESIDENT & ADMINISTRATOR
(501) 887-3221
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
10/11/2012
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