340B Drug Pricing Program Database

Pharmacy Name

FRED'S XPRESS #3861

Pharmacy Address

705 PLANK ROAD
PO BOX 5
ST JOSEPH, LA 71366

Pharmacy Comments

Approval Date

4/15/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/18/2018
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

JACQUELINE D. SCHAUF, CEO/EXECUTIVE DIRECTOR
(318) 766-1967

Contract Pharmacy Representative

Shannon Strickland, SVP, Pharmacy Development
(901) 238-3113

Signed By Date

4/15/2016