340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-0015

Pharmacy Address

1310 PREACHER ROE BLVD
WEST PLAINS, MO 65775

Pharmacy Comments

Approval Date

2/28/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Kim Thompson, CFO
(417) 256-9111 Ext: 6031

Contract Pharmacy Representative

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

Signed By Date

3/1/2013