340B Drug Pricing Program Database

Pharmacy Name

RALEY'S PHARMACY #445

Pharmacy Address

311 SOUTH LOWER SACRAMENTO RD.
LODI, CA 95242

Pharmacy Comments

Approval Date

8/3/2015

Contract Begin Date

10/1/2015

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Terry Deak, VP & Chief Financial Officer
(209) 339-7898

Contract Pharmacy Representative

Debi Austin, Pharmacy Operations
(916) 373-6042

Signed By Date

8/3/2015