340B Drug Pricing Program Database

Pharmacy Name

HY-VEE PHARMACY #1872

Pharmacy Address

1311 4TH STREET SW
WAVERLY, IA 50677

Pharmacy Comments

Approval Date

7/12/2013

Contract Begin Date

10/1/2013

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Kyle Richards, CEO
(319) 352-4941

Contract Pharmacy Representative

Hy-Vee Inc
Matt Pertzborn, Director, Pharm Bus Dvpt
(515) 559-5761

Signed By Date

7/12/2013