340B Drug Pricing Program Database

Pharmacy Name

LEWIS FAMILY DRUG #51

Pharmacy Address

202 S KNISS AVE
LUVERNE, MN 56156-1775

Pharmacy Comments

Approval Date

7/9/2013

Contract Begin Date

10/1/2013

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Tammy Loosbrock, CEO
(712) 472-2591 Ext: 141

Contract Pharmacy Representative

Lewis Drug
Scott Cross, EVP
(605) 367-2800

Signed By Date

7/9/2013