340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-1872

Pharmacy Address

2750 PROSPECT AVENUE
HELENA, MT 59601

Pharmacy Comments

Approval Date

4/11/2019

Contract Begin Date

3/15/2022

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Nathan M Coburn, CFO
(406) 444-2122

Contract Pharmacy Representative

Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498

Signed By Date

4/11/2019