340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0870
FQHCLA359A Southern Indiana Community Health Care Inc
Print
Covered Entity Details
Entity Name
Southern Indiana Community Health Care Inc
Subdivision Name
Valley Health
Type
Health Center Program Look-Alike
340B ID
FQHCLA359A
Entity Address
8163 West State Road 56, Suite A
West Baden Springs, IN 47469
Grant Number
LALCS31528
Participating Start Date
1/1/2018
Last Recertification Date
2/19/2019
Entity Termination Date
4/1/2020
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0870
Pharmacy Address
4040 NEWTON ST
JASPER, IN 47546
Pharmacy Comments
Contract Details
Approval Date
1/15/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Nancy Radcliff, CEO
(812) 723-3944
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/15/2018
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