340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0031
DSH370040 Leflore County Hospital Authority
Print
Covered Entity Details
Entity Name
Leflore County Hospital Authority
Subdivision Name
Eastern Oklahoma Medical Center
Type
Disproportionate Share Hospital
340B ID
DSH370040
Entity Address
105 Wall Street
Poteau, OK 74953-1148
Medicare Provider Number
370040
Participating Start Date
7/1/2013
Last Recertification Date
8/10/2016
Entity Termination Date
4/1/2017
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0031
Pharmacy Address
3108 N. BROADWAY
POTEAU, OK 74953
Pharmacy Comments
Contract Details
Approval Date
1/15/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2017
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Mike Carter, CEO
(918) 635-3402
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/15/2014
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