340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-1806

Pharmacy Address

329 SOUTH KINGSBORO AVE.
GLOVERSVILLE, NY 12078

Pharmacy Comments

02/04/2013 city update (was JOHNSTOWN)

Approval Date

10/22/2012

Contract Begin Date

10/22/2012

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Henry Legendziewicz, Senior Vice Pres & CFO
(518) 773-5480

Contract Pharmacy Representative

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

Signed By Date

9/20/2012