340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-5492
CAH321301-00 SOCORRO GENERAL HOSPITAL
Print
Covered Entity Details
Entity Name
SOCORRO GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH321301-00
Entity Address
1202 HIGHWAY 60 WEST
SOCORRO, NM 87801
Medicare Provider Number
321301
Participating Start Date
1/1/2017
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5492
Pharmacy Address
700 NORTH 6TH STREET
SOCORRO, NM 87801
Pharmacy Comments
Contract Details
Approval Date
11/1/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DALE MAXWELL, SENIOR VP & CFO
(505) 923-5353
Contract Pharmacy Representative
Robert Love, Data Analyst
(908) 642-8060
Signed By Date
11/1/2016
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