340B Drug Pricing Program Database

Pharmacy Name

SMITH'S PHARMACY #94

Pharmacy Address

455 SOUTH 500 EAST
SALT LAKE CITY, UT 84102

Pharmacy Comments

Approval Date

1/30/2012

Contract Begin Date

1/31/2012

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

DEXTER PEARCE, Executive Director
(801) 412-6920

Contract Pharmacy Representative

Smiths Food & Drug Centers
Blair Woolf, Pharmacy Director
(801) 974-1302

Signed By Date

1/16/2012