340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0166
CH07440G DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
Print
Covered Entity Details
Entity Name
DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
Subdivision Name
Missouri Ozarks Community Health
Type
HRSA-Funded Health Center
340B ID
CH07440G
Entity Address
1604 C North Main Street
Mountain Grove, MO 65711
Grant Number
H80CS00457
Participating Start Date
1/1/2016
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0166
Pharmacy Address
1433 SOUTH SAM HOUSTON BLVD.
HOUSTON, MO 65483
Pharmacy Comments
Contract Details
Approval Date
10/9/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tim R Shryack, CEO
(417) 683-4831 Ext: 110
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
10/9/2017
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