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WALTERS DRUG INC
CAH341320-00 ALLEGHANY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
ALLEGHANY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH341320-00
Entity Address
233 DOCTORS STREET
SPARTA, NC 28675
Medicare Provider Number
341320
Participating Start Date
1/1/2011
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
WALTERS DRUG INC
Pharmacy Address
533 E MAIN STREET
P. O. BOX 250
INDEPENDENCE, VA 24348
Pharmacy Comments
Contract Details
Approval Date
4/15/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brett Liverman, CFO
(336) 372-3276
Contract Pharmacy Representative
Jean Lindsey, President
(276) 773-2351
Signed By Date
4/15/2014
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