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WAL-MART PHARMACY 10-0619
CAH441310-00 RHEA MEDICAL CENTER
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Covered Entity Details
Entity Name
RHEA MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH441310-00
Entity Address
9400 RHEA COUNTY HIGHWAY
DAYTON, TN 37321
Medicare Provider Number
441310
Participating Start Date
1/1/2015
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0619
Pharmacy Address
3034 RHEA COUNTY HWY
DAYTON, TN 37321
Pharmacy Comments
Contract Details
Approval Date
10/8/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/1/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Marilyn Engel, Business Office Director
(423) 775-8588
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
10/8/2015
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