340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0305
CAH251322-00 LAIRD HOSPITAL, INC.
Print
Covered Entity Details
Entity Name
LAIRD HOSPITAL, INC.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH251322-00
Entity Address
25117 HWY 15 BYPASS
UNION, MS 39365
Medicare Provider Number
251322
Participating Start Date
1/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0305
Pharmacy Address
905 HIGHWAY 16 WEST
CARTHAGE, MS 39051
Pharmacy Comments
Contract Details
Approval Date
10/16/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/9/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
THOMAS BARTLETT, HOSPITAL ADMINISTRATOR
(601) 774-8214 Ext: 1500
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
10/16/2013
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