340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-1569
CH048980 LEWIS COUNTY PRIMARY CARE CENTER, INC.
Print
Covered Entity Details
Entity Name
LEWIS COUNTY PRIMARY CARE CENTER, INC.
Subdivision Name
Lewis County Primary Care Center, Inc.
Type
HRSA-Funded Health Center
340B ID
CH048980
Entity Address
211 KY 59
Building A
VANCEBURG, KY 41179
Grant Number
H80CS00106
Participating Start Date
1/1/1999
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1569
Pharmacy Address
240 WAL-MART WAY
MAYSVILLE, KY 41056
Pharmacy Comments
Contract Details
Approval Date
4/3/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JERRY UGRIN, CEO
(606) 796-3029
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/3/2014
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