340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY #10-2474
CHC06642-00 WESTERN MARYLAND HEALTH CARE CORPORATION
Print
Covered Entity Details
Entity Name
WESTERN MARYLAND HEALTH CARE CORPORATION
Subdivision Name
Mountain Laurel Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC06642-00
Entity Address
1027 Memorial Dr
Oakland, MD 21550-4343
Grant Number
H80CS06642
Participating Start Date
4/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY #10-2474
Pharmacy Address
R.R. #4 BOX 82
KEYSER, WV 26726
Pharmacy Comments
Contract Details
Approval Date
7/18/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Charles Lee Wilt, CEO
(301) 533-3300 Ext: 3056
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
7/18/2017
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