340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2052
CAH051310-00 Willits Hospital Inc., DBA Adventist Health Howard Memorial
Print
Covered Entity Details
Entity Name
Willits Hospital Inc., DBA Adventist Health Howard Memorial
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH051310-00
Entity Address
One Marcela Drive
Willits, CA 95490-5769
Medicare Provider Number
051310
Participating Start Date
10/1/2011
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2052
Pharmacy Address
1155 AIRPORT PARK BLVD.
UKIAH, CA 95482
Pharmacy Comments
Contract Details
Approval Date
2/28/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brandon Parker, CFO
(707) 467-5270
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/15/2013
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