340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-2592

Pharmacy Address

1807 WEST CRAIG ROAD
NORTH LAS VEGAS, NV 89032

Pharmacy Comments

Approval Date

5/1/2023

Contract Begin Date

5/17/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2025
Covered Entity Terminated

Covered Entity Signing Official

Jami Dybik, Vice President
(843) 814-5177

Contract Pharmacy Representative

Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498

Signed By Date

4/24/2023