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WAL-MART PHARMACY 10-5997
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 10-5997
Pharmacy Address
9600 PARKSOUTH CT. SUITE 100
ORLANDO, FL 32837
Pharmacy Comments
Contract Details
Approval Date
7/13/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brent Beaulieu, CFO
(501) 202-2017
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/13/2017
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