340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-5315
DSH450755 Methodist Hospital Levelland (DBA Covenant Hospital Levelland)
Print
Covered Entity Details
Entity Name
Methodist Hospital Levelland (DBA Covenant Hospital Levelland)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450755
Entity Address
1900 COLLEGE AVE
LEVELLAND, TX 79336
Medicare Provider Number
450755
Participating Start Date
7/1/2011
Last Recertification Date
9/13/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5315
Pharmacy Address
2354 COMMERCE PARK DR.
ORLANDO, FL 32819
Pharmacy Comments
Contract Details
Approval Date
1/9/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/12/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Newman D. Wheeler, COO/CFO
(806) 568-1304
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
1/9/2017
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