340B Drug Pricing Program Database

Pharmacy Name

PIGGLY WIGGLY PHARMACY #48

Pharmacy Address

269 NORTH RON MCNAIR BOULEVARD
LAKE CITY, SC 29560

Pharmacy Comments

10/25/2010 - ADDRESS CHANGED FROM 212 WEST MAIN STREET.

Approval Date

7/15/2013

Contract Begin Date

10/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/27/2018
Ownership change

Covered Entity Signing Official

Carl Humphries, CEO
(843) 667-9414 Ext: 1500

Contract Pharmacy Representative

SPENCER PLAYER, OWNER
(843) 394-3121

Signed By Date

7/15/2013