340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-5997

Pharmacy Address

9600 PARKSOUTH CT. SUITE 100
ORLANDO, FL 32837

Pharmacy Comments

Approval Date

2/23/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Alicia Maitland, CFO
(231) 935-7840

Contract Pharmacy Representative

Wal-Mart
Jodi Prohofsky, Sr. Director, Payer Relations
(254) 301-6601

Signed By Date

1/18/2022