340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-0790

Pharmacy Address

1902 WEST "B"
MCCOOK, NE 69001

Pharmacy Comments

Approval Date

10/15/2012

Contract Begin Date

10/15/2012

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

TROY BRUNTZ, Vice President, Finance
(308) 344-8315

Contract Pharmacy Representative

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

Signed By Date

9/13/2012