340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-0096

Pharmacy Address

1700 NORTH 291 HWY
HARRISONVILLE, MO 64701

Pharmacy Comments

Approval Date

4/15/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

BRENT PROBASCO, CFO
(816) 380-5888 Ext: 6610

Contract Pharmacy Representative

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

Signed By Date

4/15/2020