340B Drug Pricing Program Database

Pharmacy Name

MISSOURI CVS PHARMACY, L.L.C.

Pharmacy Address

CVS PHARMACY # 17093
5201 N BELT HWY STE H
SAINT JOSEPH, MO 64506

Pharmacy Comments

Approval Date

4/14/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2020
Covered Entity Terminated

Covered Entity Signing Official

Dwain Stilson, Chief Financial Officer
(816) 271-7070

Contract Pharmacy Representative

CVS
Christian Reid, 340B Program Director, CVS Pharmacy
(401) 770-2118

Signed By Date

4/13/2020