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WAL-MART CENTRAL FILL 10-2670
CAH451387-00 Uvalde Memorial Hospital
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Covered Entity Details
Entity Name
Uvalde Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH451387-00
Entity Address
1025 Garner Field Road
Uvalde, TX 78801
Medicare Provider Number
451387
Participating Start Date
7/1/2017
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WAL-MART CENTRAL FILL 10-2670
Pharmacy Address
608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386
Pharmacy Comments
Contract Details
Approval Date
7/6/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Valerie J. Lopez, Chief Financial Officer
(830) 278-6251 Ext: 1173
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/6/2017
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