340B Drug Pricing Program Database

Pharmacy Name

WAL-MART PHARMACY 10-0927

Pharmacy Address

1501 NORTH I-27
PLAINVIEW, TX 79072

Pharmacy Comments

Approval Date

9/25/2013

Contract Begin Date

10/1/2013

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

CLAY TAYLOR, CFO/COO
(806) 296-4265

Contract Pharmacy Representative

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

Signed By Date

9/25/2013