340B Drug Pricing Program Database

Pharmacy Name

WALMART PHARMACY 10-4865

Pharmacy Address

5200 WEST 60TH STREET NORTH
SIOUX FALLS, SD 57107

Pharmacy Comments

Approval Date

4/15/2015

Contract Begin Date

7/1/2015

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

DAVE KAPASKA, REGIONAL PRESIDENT/CEO
(605) 322-7808

Contract Pharmacy Representative

Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719

Signed By Date

4/15/2015