340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0369
SCH170150-00 SOUTH CENTRAL KS REGIONAL MEDICAL CT
Print
Covered Entity Details
Entity Name
SOUTH CENTRAL KS REGIONAL MEDICAL CT
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH170150-00
Entity Address
6401 Patterson Parkway
ARKANSAS CITY, KS 67005
Medicare Provider Number
170150
Participating Start Date
10/1/2015
Last Recertification Date
8/23/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0369
Pharmacy Address
2202 PIKE RD.
WINFIELD, KS 67156
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Holly Harper, CFO
(620) 441-5924
Contract Pharmacy Representative
South Central Kansas Regional Medical Center
Homer Mah, Pharmacist
(620) 441-5725
Signed By Date
1/12/2018
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