340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-2228

Pharmacy Address

555 HUBBARD AVENUE SUITE 12
PITTSFIELD, MA 01201

Pharmacy Comments

Approval Date

7/8/2015

Contract Begin Date

10/1/2015

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

DARLENE RODOWICZ, Executive Vice President & Treasurer
(413) 447-2809

Contract Pharmacy Representative

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

Signed By Date

7/8/2015