340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-0243

Pharmacy Address

1971 WENTZVILLE PARKWAY
WENTZVILLE, MO 63385

Pharmacy Comments

Approval Date

7/3/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Jake Matthew Krafve, Chief Financial Officer
(636) 332-8392

Contract Pharmacy Representative

WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498

Signed By Date

7/3/2018