340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-3307

Pharmacy Address

35 MIKE STEWART DRIVE
CRAWFORDVILLE, FL 32327

Pharmacy Comments

Approval Date

7/23/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/10/2019
Agreement registered in error

Covered Entity Signing Official

Thomas J. Stone, Chief Executive Officer
(850) 584-0886

Contract Pharmacy Representative

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

Signed By Date

7/12/2019