340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0158
CAH451370-00 Fannin County Hospital Authority
Print
Covered Entity Details
Entity Name
Fannin County Hospital Authority
Subdivision Name
TMC Bonham Hospital
Type
Critical Access Hospital
340B ID
CAH451370-00
Entity Address
504 Lipscomb St
Bonham, TX 75418
Medicare Provider Number
451370
Participating Start Date
4/1/2014
Last Recertification Date
9/11/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0158
Pharmacy Address
2021 NORTH HWY. 121
BONHAM, TX 75418
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
Jay Hodges, CFO
(903) 640-7311
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/15/2014
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