340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-1445
CAH361314-02 H. B. MAGRUDER MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
H. B. MAGRUDER MEMORIAL HOSPITAL
Subdivision Name
MAGRUDER HOSPITAL PAIN MANAGEMENT
Type
Critical Access Hospital
340B ID
CAH361314-02
Entity Address
611 FULTON STREET, SUITE D
PORT CLINTON, OH 43452-2008
Medicare Provider Number
361314
Outpatient Facility Provider Number
Participating Start Date
10/1/2015
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1445
Pharmacy Address
2826 E. HARBOR ROAD
PORT CLINTON, OH 43452
Pharmacy Comments
Contract Details
Approval Date
10/10/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Todd J. Almendinger, President/CEO
(419) 734-3131 Ext: 3100
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
10/10/2017
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