340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-1936

Pharmacy Address

3763 I-75 BUSINESS SPUR
SAULT SAINTE MARIE, MI 49783

Pharmacy Comments

Approval Date

7/7/2014

Contract Begin Date

10/1/2014

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

DAVID JAHN, PRESIDENT & CHIEF EXECUTIVE OFFICER
(906) 635-4650

Contract Pharmacy Representative

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

Signed By Date

7/7/2014