340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0176
CAH250010-00 TIPPAH COUNTY HOSPITAL
Print
Covered Entity Details
Entity Name
TIPPAH COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH250010-00
Entity Address
1005 CITY AVE N
RIPLEY, MS 38663
Medicare Provider Number
250010
Participating Start Date
10/1/2015
Last Recertification Date
8/21/2018
Entity Termination Date
10/1/2019
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0176
Pharmacy Address
822 CITY AVE SOUTH
RIPLEY, MS 38663
Pharmacy Comments
Contract Details
Approval Date
1/8/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Bob Jones, Interim CEO
(662) 837-9221
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/8/2016
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