340B Drug Pricing Program Database

Pharmacy Name

SMITH'S PHARMACY #28

Pharmacy Address

922 E. 2100 S.
SALT LAKE CITY, UT 84106

Pharmacy Comments

Approval Date

10/29/2018

Contract Begin Date

1/1/2019

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

DEXTER PEARCE, Executive Director
(801) 412-6920

Contract Pharmacy Representative

SFDC
Julie Arellano, Third Party Insurance Coordinator
(801) 974-1402

Signed By Date

10/15/2018