340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2562
CAH171370-00 GOODLAND REGIONAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
GOODLAND REGIONAL MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171370-00
Entity Address
220 WEST SECOND STREET
GOODLAND, KS 67735
Medicare Provider Number
171370
Participating Start Date
1/1/2011
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2562
Pharmacy Address
2160 COMMERCE ROAD
GOODLAND, KS 67735
Pharmacy Comments
Contract Details
Approval Date
4/10/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marion A. Thompson, CEO
(785) 890-6001
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
4/10/2014
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