340B Drug Pricing Program Database

Pharmacy Name

DILLONS PHARMACY #89

Pharmacy Address

1910 W 21ST ST NORTH
WICHITA, KS 67203

Pharmacy Comments

Approval Date

4/10/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

TERESA LOVELADY, CHIEF EXECUTIVE OFFICER
(316) 691-9404

Contract Pharmacy Representative

Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875

Signed By Date

4/10/2020