340B Drug Pricing Program Database

Pharmacy Name

KROGER PHARMACY #613

Pharmacy Address

1295 WEST MAIN STREET
CABOT, AR 72023

Pharmacy Comments

Approval Date

10/18/2011

Contract Begin Date

10/18/2011

Carve-In Effective Date

Contract Comments

9/28/12 entity and associated contracts terminated this day at request of CE, which later communicated that the request to terminate was a mistake so entity was unterminated the same day, termination date of 10/1/12 for CP was removed on 9/30/12

Covered Entity Signing Official

TALMAGE J. WHITEHEAD, CHIEF FINANCIAL OFFICER
(870) 347-3300

Contract Pharmacy Representative

Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672

Signed By Date

10/12/2011