340B Drug Pricing Program Database

Pharmacy Name

THE PRESCRIPTION SHOP

Pharmacy Address

120 S. GRAND AVENUE SUITE #1
WAXAHACHIE, TX 75165

Pharmacy Comments

Approval Date

1/15/2016

Contract Begin Date

4/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/28/2016
Agreement registered in error

Covered Entity Signing Official

Barbara Clark, CEO
(972) 923-2440 Ext: 201

Contract Pharmacy Representative

mike boyd, owner
(215) 836-1213

Signed By Date

1/15/2016