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WAL-MART PHARMACY 10-1352
DSH340120 DUPLIN GENERAL HOSPITAL, INC. D/B/A ECU HEALTH DUPLIN HOSPITAL
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Covered Entity Details
Entity Name
DUPLIN GENERAL HOSPITAL, INC. D/B/A ECU HEALTH DUPLIN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340120
Entity Address
401 NORTH MAIN STREET
KENANSVILLE, NC 28349
Medicare Provider Number
340120
Participating Start Date
7/1/2004
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1352
Pharmacy Address
5625 SOUTH NC HWY 41
WALLACE, NC 28466
Pharmacy Comments
Contract Details
Approval Date
4/16/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LUCINDA CRAWFORD, VICE PRESIDENT OF FINANCIAL SERVICES
(910) 296-2608
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/16/2018
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