340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-0657

Pharmacy Address

768 S JEFFERSON AVE
COOKEVILLE, TN 38501

Pharmacy Comments

Approval Date

2/14/2023

Contract Begin Date

4/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/4/2023
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

PAUL Dudley KORTH, CEO
(931) 783-2000

Contract Pharmacy Representative

Wal--Mart
Marcus Osborne, Sales & Contracting
(479) 204-8452

Signed By Date

1/16/2023