340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-5373
CAH521328-00 MARSHFIELD MEDICAL CENTER LADYSMITH
Print
Covered Entity Details
Entity Name
MARSHFIELD MEDICAL CENTER LADYSMITH
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH521328-00
Entity Address
1200 Port Arthur Road
LADYSMITH, WI 54848
Medicare Provider Number
521328
Participating Start Date
10/1/2019
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5373
Pharmacy Address
2786 COMMERICAL BLVD
CHIPPEWA FALLS, WI 54729
Pharmacy Comments
Contract Details
Approval Date
4/13/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/11/2018
Agreement registered in error
Contacts
Covered Entity Signing Official
David J Kuehn, Chief Financial Officer
(715) 532-5561 Ext: 1106
Contract Pharmacy Representative
Rusk County Memorial Hospital
Paul E Finn, Pharmacy Director
(715) 532-5561 Ext: 3122
Signed By Date
4/13/2018
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