340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-4374

Pharmacy Address

2301 EAST FRONTAGE ROAD
LITCHFIELD, MN 55355

Pharmacy Comments

Approval Date

4/5/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Nicole Siegner, Chief Finance Officer
(320) 693-4512

Contract Pharmacy Representative

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

Signed By Date

4/5/2020