340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-5981

Pharmacy Address

6005 MADISON AVE
CARMICHAEL, CA 95608

Pharmacy Comments

Approval Date

3/8/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/24/2017
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Bob Pascuzzi, Chief Financial Officer
(916) 537-5000

Contract Pharmacy Representative

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

Signed By Date

1/14/2013