340B Drug Pricing Program Database

Pharmacy Name

FAIRVIEW PHARMACY MAPLEWOOD

Pharmacy Address

2945 HAZELWOOD STREET SUITE 105
MAPLEWOOD, MN 55109

Pharmacy Comments

Approval Date

4/16/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Trudi Noel Trysla, Chief Legal Officer
(612) 672-6382

Contract Pharmacy Representative

Fairview Pharmacy Services
John Pastor, System VP Pharmacy and Respiratory Care
(612) 672-5153

Signed By Date

4/15/2025