340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-2587

Pharmacy Address

304 SOUTH ROCKWOOD
CABOT, AR 72023

Pharmacy Comments

Approval Date

7/23/2012

Contract Begin Date

7/23/2012

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, President/CFO
(870) 347-3414

Contract Pharmacy Representative

Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374

Signed By Date

7/19/2012