340B Drug Pricing Program Database


CH04245AD WHATLEY HEALTH SERVICES INC (Active) - information as of 4/30/2025 10:49:58 PM

Main Details
WHATLEY HEALTH SERVICES INC
Whatley Health Services at Aliceville
HRSA-Funded Health Center
BPS-H80-036155
CH04245AD
H80CS00094


Additional Details
Active
10/6/2023
1/1/2024
10/6/2023
2/10/2025

Contacts

Whatley Health Services
David Gay, CEO
(205) 614-6135

Whatley Health Services
Rajuan Sherman, Chief Financial Officer
(205) 614-6070

Addresses

432 5th St NW
Aliceville, AL 35442

Whatley Health Services, Inc.
P.O. Box 2400
Tuscaloosa, AL 35403-2400


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
AL630000005,3122571063422756,1295447787
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04946 113 3RD ST SE
ALICEVILLEAL3544210/14/202301/01/2024  01/01/2024
Contract DetailALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04969 536 HUDSON DR., PO BOX 653
GORDOAL3546610/14/202301/01/2024  01/01/2024
Contract DetailALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04835 1910 MCFARLAND BOULEVARD
NORTHPORTAL3547610/14/202301/01/2024  01/01/2024
Contract DetailH & W APOTHECARY211 1ST ST S
REFORMAL35481-801710/14/202301/01/2024  01/01/2024
Contract DetailWALGREEN CODBA: WALGREENS #11404 4400 UNIVERSITY BLVD E
TUSCALOOSAAL35404-510410/16/202301/01/2024  01/01/2024
Contract DetailWALGREEN CODBA: WALGREENS #11450 879 HIGHWAY 78
SUMITONAL3514810/16/202301/01/2024  01/01/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 05861 3107 LURLEEN B WALLACE BLVD
NORTHPORTAL3547610/16/202301/01/2024  01/01/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 09683 100 N AIRPORT RD
JASPERAL35504-752010/16/202301/01/2024  01/01/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 10525 8701 HIGHWAY 69 S
TUSCALOOSAAL35405-846510/16/202301/01/2024  01/01/2024
Contract DetailWALGREEN CO.WALGREENS #17955 3206 15TH ST
TUSCALOOSAAL35401-400210/16/202301/01/2024  01/01/2024
Contract DetailWALGREEN CO.WALGREENS #18125 4200 MCFARLAND BLVD E STE 6
TUSCALOOSAAL3540510/16/202301/01/2024  01/01/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 02676 1728 HIGHWAY 45 NORTH
COLUMBUSMS3970510/16/202301/01/2024  01/01/2024
Contract DetailWALGREEN CO.WALGREENS #18116 521 UNIVERSITY BLVD E
TUSCALOOSAAL35401-202310/16/202301/01/2024  01/01/2024
Contract DetailWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16371 3686 GRANDVIEW PKWY STE 120
BIRMINGHAMAL3524310/16/202301/01/2024  01/01/2024
Contract DetailWalgreens #21389Walgreens Central Fill #21389 3299 Tchulatech Dr
Suite 101
MemphisTN3811810/16/202301/01/2024  01/01/2024
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH042450ActiveBPS-H80-000345WHATLEY HEALTH SERVICES, INC.Maude L. Whatley Health Center2731 MARTIN L KING JR. BLVD. TUSCALOOSAAL
CH04245AATerminatedBPS-H80-018684WHATLEY HEALTH SERVICES, INC.Oakman Student Health and Wellness Center142 School Street OakmanAL
CH04245ABTerminatedBPS-H80-024389WHATLEY HEALTH SERVICES, INC.Aliceville Health and Wellness Center417 3rd St SE AlicevilleAL
CH04245ACTerminatedBPS-H80-031820Whatley Health Services, Inc.Stillman Health Center3601 STILLMAN BLVD TUSCALOOSAAL
CH04245ADActiveBPS-H80-036155WHATLEY HEALTH SERVICES INCWhatley Health Services at Aliceville432 5th St NW AlicevilleAL
CH04245CTerminatedBPS-H80-002151WHATLEY HEALTH SERVICES, INC.JAMES O. ELLIS HEALTH CENTER3532 GREENSBORO AVE. TUSCALOOSAAL
CH04245EActiveBPS-H80-038818WHATLEY HEALTH SERVICES, INC.SUMTER COUNTY HEALTH CENTER107 HOSPITAL DRIVE LIVINGSTONAL
CH04245FTerminatedBPS-H80-003929WHATLEY HEALTH SERVICES, INC.WEST BLOCTON HEALTH CTR345 MAGNOLIA STREET WEST BLOCTONAL
CH04245GTerminatedBPS-H80-005587WHATLEY HEALTH SERVICES, INC.HALE COUNTY HEALTH CENTER602 Centerville St GreensboroAL
CH04245HActiveBPS-H80-001729WHATLEY HEALTH SERVICES, INC.WHATLEY HEALTH SERVICES @ EUTAW200 MORROW AVE EUTAWAL
CH04245IActiveBPS-H80-001334WHATLEY HEALTH SERVICES, INC.WHATLEY HEALTH SVS @ SIPSEY3805 SIPSEY ROAD SIPSEYAL
CH04245JTerminatedBPS-H80-005379WHATLEY HEALTH SERVICES, INC.WHATLEY HLTH SERV AT OAKMAN10290 MAIN ST OAKMANAL
CH04245QActiveBPS-H80-002800WHATLEY HEALTH SERVICES, INC.Vernon Health Center230 Hospital Drive VernonAL
CH04245RActiveBPS-H80-013308WHATLEY HEALTH SERVICES, INC.Pickens County Family Practice Center27340 Highway 86 GordoAL
CH04245SActiveBPS-H80-008800WHATLEY HEALTH SERVICES, INC.LaBridgette R. Ellis Medical and Dental Center800 Hall Street GreensboroAL
CH04245TTerminatedBPS-H80-007267WHATLEY HEALTH SERVICES, INC.CRESCENT EAST HEALTH CENTER120 51st Ave E APT B TuscaloosaAL
CH04245UTerminatedBPS-H80-003714WHATLEY HEALTH SERVICES, INC.TUSCALOOSA COUNTY JAIL1616 26TH AVE TUSCALOOSAAL
CH04245VActiveBPS-H80-000373WHATLEY HEALTH SERVICES, INC.Mobile Health Unit2731 Martin L. King, Jr., Blvd. TuscaloosaAL
CH04245WActiveBPS-H80-000107WHATLEY HEALTH SERVICES, INC.Theodore Hendrix Dental Center2731 Martin L. King, Jr., Blvd. TuscaloosaAL
CH04245XActiveBPS-H80-034121WHATLEY HEALTH SERVICES, INC.Whatley Health Services at Carrollton376 Commerce Ave CarrolltonAL
CH04245YTerminatedBPS-H80-015076WHATLEY HEALTH SERVICES, INC.Stillman Health Center3601 STILLMAN BLVD TUSCALOOSAAL
CH04245ZTerminatedBPS-H80-015181WHATLEY HEALTH SERVICES, INC.Crescent East Health Center4952 1ST ST E TUSCALOOSAAL
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH042450ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884910/01/2024  
CH042450ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750210/01/2024  
CH042450ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201010/01/2024  
CH042450ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282210/01/2024  
CH042450ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349210/01/2024  
CH042450ACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607510/01/2024  
CH042450ADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101
ORLANDOFL3280901/01/2025  
CH042450ADVANCED PHARMACY, LLCADVANCED PHARMACY 350 FEASTER ROAD
SUITE D
GREENVILLESC29615-617607/01/2016 08/16/2022
CH042450AHSSHCEXPEDIEN RX PHARMACY 5050 WESLEY RD STE 120
APOPKAFL3271201/01/2016 11/27/2020
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04917 675 TUSCALOOSA STREET
GREENSBOROAL3674401/01/2017  
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04872 3302 15TH STREET
TUSCALOOSAAL3540101/01/2017  
CH042450ALABAMA CVS PHARMACY, L.L.C.CVS/PHARMACY #10811 1218 UNIVERSITY BLVD.
TUSCALOOSAAL3540101/01/2020  
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04835 1910 MCFARLAND BOULEVARD
NORTHPORTAL3547601/01/2020  
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03004 8700 HWY 69 SOUTH
TUSCALOOSAAL3540501/01/2020  
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04819 808 VETERANS MEMORIAL PKWY
TUSCALOOSAAL3540401/01/2020  
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07217 4715 RICE MINE RD. NE
TUSCALOOSAAL3540601/01/2020  
CH042450ALABAMA CVS PHARMACY, L.L.C.CVS PHARMACY # 16910 1901 13TH AVE E
TUSCALOOSAAL3540401/01/2020  
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04969 536 HUDSON DR., PO BOX 653
GORDOAL3546601/01/2020  
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04853 520 HIGHLAND AVENUE
SELMAAL3670104/13/2022  
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04813 4260 UNIVERSITY BLVD EAST
TUSCALOOSAAL3540404/13/2022  
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04834 101 N. AIRPORT RD.
JASPERAL3550404/13/2022  
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04372 4280 MITT LARY RD.
NORTHPORTAL3547504/13/2022  
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04957 312 HWY 80 EAST
DEMOPOLISAL3673204/13/2022 08/15/2024
CH042450ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04946 113 3RD ST SE
ALICEVILLEAL3544201/01/2023  
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04835 1910 MCFARLAND BOULEVARD
NORTHPORTAL3547601/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04969 536 HUDSON DR., PO BOX 653
GORDOAL3546601/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04834 101 N. AIRPORT RD.
JASPERAL3550401/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04957 312 HWY 80 EAST
DEMOPOLISAL3673201/01/2024 08/15/2024
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04946 113 3RD ST SE
ALICEVILLEAL3544201/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04834 101 N. AIRPORT RD.
JASPERAL3550401/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04917 675 TUSCALOOSA STREET
GREENSBOROAL3674401/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04872 3302 15TH STREET
TUSCALOOSAAL3540101/01/2024  
CH04245SALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04917 675 TUSCALOOSA STREET
GREENSBOROAL3674401/01/2024  
CH04245SALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03004 8700 HWY 69 SOUTH
TUSCALOOSAAL3540501/01/2024  
CH04245SALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04957 312 HWY 80 EAST
DEMOPOLISAL3673201/01/2024 08/15/2024
CH04245SALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04834 101 N. AIRPORT RD.
JASPERAL3550401/01/2024  
CH04245SALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04835 1910 MCFARLAND BOULEVARD
NORTHPORTAL3547601/01/2024  
CH04245SALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04969 536 HUDSON DR., PO BOX 653
GORDOAL3546601/01/2024  
CH04245SALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04946 113 3RD ST SE
ALICEVILLEAL3544201/01/2024  
CH04245RALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04969 536 HUDSON DR., PO BOX 653
GORDOAL3546601/01/2024  
CH04245RALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04834 101 N. AIRPORT RD.
JASPERAL3550401/01/2024  
CH04245RALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04835 1910 MCFARLAND BOULEVARD
NORTHPORTAL3547601/01/2024  
CH04245RALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04946 113 3RD ST SE
ALICEVILLEAL3544201/01/2024  
CH04245XALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04969 536 HUDSON DR., PO BOX 653
GORDOAL3546601/01/2024  
CH04245XALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04946 113 3RD ST SE
ALICEVILLEAL3544201/01/2024  
CH04245ADALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04946 113 3RD ST SE
ALICEVILLEAL3544201/01/2024  
CH04245ADALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04969 536 HUDSON DR., PO BOX 653
GORDOAL3546601/01/2024  
CH04245ADALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04835 1910 MCFARLAND BOULEVARD
NORTHPORTAL3547601/01/2024  
CH04245EALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04957 312 HWY 80 EAST
DEMOPOLISAL3673201/01/2024 08/15/2024
CH04245AAALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04835 1910 MCFARLAND BOULEVARD
NORTHPORTAL3547601/01/2024 01/01/2025
CH04245AAALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04834 101 N. AIRPORT RD.
JASPERAL3550401/01/2024 01/01/2025
CH04245EALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04969 536 HUDSON DR., PO BOX 653
GORDOAL3546601/01/2024  
CH04245EALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04946 113 3RD ST SE
ALICEVILLEAL3544201/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.CVS/PHARMACY #10811 1218 UNIVERSITY BLVD.
TUSCALOOSAAL3540101/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03004 8700 HWY 69 SOUTH
TUSCALOOSAAL3540501/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04819 808 VETERANS MEMORIAL PKWY
TUSCALOOSAAL3540401/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07217 4715 RICE MINE RD. NE
TUSCALOOSAAL3540601/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.CVS PHARMACY # 16910 1901 13TH AVE E
TUSCALOOSAAL3540401/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04813 4260 UNIVERSITY BLVD EAST
TUSCALOOSAAL3540401/01/2024  
CH04245HALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04853 520 HIGHLAND AVENUE
SELMAAL3670101/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04917 675 TUSCALOOSA STREET
GREENSBOROAL3674401/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04872 3302 15TH STREET
TUSCALOOSAAL3540101/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.CVS/PHARMACY #10811 1218 UNIVERSITY BLVD.
TUSCALOOSAAL3540101/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04835 1910 MCFARLAND BOULEVARD
NORTHPORTAL3547601/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03004 8700 HWY 69 SOUTH
TUSCALOOSAAL3540501/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04819 808 VETERANS MEMORIAL PKWY
TUSCALOOSAAL3540401/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.CVS PHARMACY # 16910 1901 13TH AVE E
TUSCALOOSAAL3540401/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04969 536 HUDSON DR., PO BOX 653
GORDOAL3546601/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04853 520 HIGHLAND AVENUE
SELMAAL3670101/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04813 4260 UNIVERSITY BLVD EAST
TUSCALOOSAAL3540401/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04372 4280 MITT LARY RD.
NORTHPORTAL3547501/01/2024  
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04957 312 HWY 80 EAST
DEMOPOLISAL3673201/01/2024 08/15/2024
CH04245IALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04946 113 3RD ST SE
ALICEVILLEAL3544201/01/2024  
CH042450AMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291110/01/2019  
CH04245AAAMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291101/01/2024 01/01/2025
CH04245HAMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291101/01/2024  
CH04245EAMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291101/01/2024  
CH042450AMAZON PHARMACY #0063620 PLAINFIELD RD
INDIANAPOLISIN46231-700310/01/2024 12/31/2024
CH042450AMAZON PHARMACY #008408 TECHNOLOGY PARKWAY BUILDING B, STE 101
COLLEGE STATIONTX7784510/01/2024 12/31/2024
CH042450AMAZON PHARMACY #0097469 KINGSPOINTE PKWY STE 400
ORLANDOFL3281910/01/2024 12/31/2024
CH042450AMAZON PHARMACY #0101331 E 6TH ST
CORONACA9287910/01/2024 12/31/2024
CH042450AVELLA OF DEER VALLEY23620 N 20TH DR #12
PHOENIXAZ85085-062101/01/2016 08/07/2020
CH042450AVELLA OF DEER VALLEY, INC. #38DBA AVELLA SPECIALTY PHARMACY 24416 N. 19TH AVE
PHOENIXAZ8508510/01/2016 08/07/2020
CH042450AVELLA OF ORLANDO100 TECHNOLOGY PARK STE 155
LAKE MARYFL32746-620501/01/2016 08/07/2020
CH042450AZ PHARMACY, LLCDBA AMAZON PHARMACY #002 3809 E WATKINS ST
PHOENIXAZ8503410/01/2024 12/31/2024
CH042450CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361404/13/2022  
CH04245ECAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/01/2024  
CH04245HCAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/01/2024  
CH04245ICAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/01/2024  
CH042450CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005604/13/2022  
CH04245ECAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/01/2024  
CH04245HCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/01/2024  
CH04245ICAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/01/2024  
CH042450CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621904/13/2022  
CH04245HCAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/01/2024  
CH04245ICAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/01/2024  
CH042450CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175704/13/2022  
CH04245HCAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/01/2024  
CH04245ICAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/01/2024  
CH042450CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808304/13/2022  
CH04245HCAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/01/2024  
CH04245ICAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/01/2024  
CH042450CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700404/13/2022  
CH04245HCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/01/2024  
CH04245ICAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/01/2024  
CH042450CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761704/13/2022  
CH04245HCAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/01/2024  
CH04245ICAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/01/2024  
CH042450CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107
BARTLETTTN3813304/13/2022  
CH04245HCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107
BARTLETTTN3813301/01/2024  
CH04245ICAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107
BARTLETTTN3813301/01/2024  
CH042450CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237404/13/2022  
CH04245HCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237401/01/2024  
CH04245ICAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237401/01/2024  
CH042450CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911904/13/2022  
CH04245HCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/01/2024  
CH04245ICAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/01/2024  
CH042450CARROLLTON DRUGS, INC25700 HIGHWAY 17
CARROLLTONAL3544701/01/2021 07/15/2021
CH042450CURANT HEALTH FLORIDA, LLC11001 ROOSEVELT BLVD STE 1400
ST PETERSBURGFL33716-233811/05/2012 07/15/2021
CH042450CURANT HEALTH GEORGIA LLCCURANT HEALTH 200 TECHNOLOGY CT SE BLDG 200
SUITE B
SMYRNAGA30082-525011/05/2012 07/15/2021
CH042450CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870604/21/2022  
CH04245HCVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870601/01/2024  
CH04245ICVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870601/01/2024  
CH042450CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005604/21/2022  
CH04245ECVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005601/01/2024  
CH04245RCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005601/01/2024  
CH04245XCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005601/01/2024  
CH04245HCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005601/01/2024  
CH04245ICVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005601/01/2024  
CH042450CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07154 5603 FM1960 W
HOUSTONTX7706904/13/2022  
CH04245ECVS PHARMACY, INC.DBA: CVS/PHARMACY # 07154 5603 FM1960 W
HOUSTONTX7706901/01/2024  
CH04245HCVS PHARMACY, INC.DBA: CVS/PHARMACY # 07154 5603 FM1960 W
HOUSTONTX7706901/01/2024  
CH042450CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502804/13/2022  
CH04245ECVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502801/01/2024  
CH04245HCVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502801/01/2024  
CH042450DELIVERCARERX PHARMACY LLCDELIVERCARERX PHARMACY LLC 1471 E BUSINESS CENTER DR
STE 200
MT PROSPECTIL6005601/01/2018 03/04/2020
CH04245EDELIVERCARERX PHARMACY LLCDELIVERCARERX PHARMACY LLC 1471 E BUSINESS CENTER DR
STE 200
MT PROSPECTIL6005601/01/2024 08/22/2024
CH042450DIVVYMED, LLCDIVVYMED LLC DBA DIVVYDOSE 4300 44TH AVE
MOLINEIL6126510/01/2024  
CH042450ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111210/01/2024  
CH042450EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313410/01/2024  
CH042450EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2024  
CH042450EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2024  
CH042450FRANK'S CARE PHARMACY  1207 STATE STREET
GREENSBOROAL3674401/01/2014 05/15/2019
CH04245GFRANK'S CARE PHARMACY  1207 STATE STREET
GREENSBOROAL3674407/01/2003 04/01/2016
CH042450GRIFFIN PHARMACY SIPSEY3844 SIPSEY RD. PO BOX 560
SIPSEYAL3558401/01/2014 05/15/2019
CH042450H & W APOTHECARY211 1ST ST S
REFORMAL35481-801701/01/2021  
CH04245RH & W APOTHECARY211 1ST ST S
REFORMAL35481-801701/01/2024  
CH04245ADH & W APOTHECARY211 1ST ST S
REFORMAL35481-801701/01/2024  
CH042450I H S PHARMACY584 MCCURDY AVE S STE 1
RAINSVILLEAL3598609/01/2020 09/30/2022
CH042450IC PHARMACY LLCAMAZON PHARMACY #004 34 35TH STREET
STE 4BSW, UNIT 28
BROOKLYNNY1123210/01/2024 12/31/2024
CH042450JACK'S DISCOUNT PHARMACYJACK'S DISCOUNT PHARMACY 23010 HIGHWAY 5
PO BOX 680
WEST BLOCTONAL35184-352210/01/2013 05/15/2019
CH042450KC DRUG, INC40870 HIGHWAY 69 SUITE D
MOUNDVILLEAL3547407/01/2016 07/01/2021
CH042450M.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312607/01/2018  
CH04245AAM.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312601/01/2024 01/01/2025
CH04245EM.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312601/01/2024  
CH04245HM.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312601/01/2024  
CH042450OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276510/01/2024  
CH042450OPTUM PHARMACY 701, LLC4015 SHOPTON RD STE 600
CHARLOTTENC28217-302510/01/2024  
CH042450OPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824910/01/2024  
CH042450OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983810/01/2024  
CH042450PILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310107/01/2018  
CH04245AAPILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310101/01/2024 01/01/2025
CH04245EPILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310101/01/2024  
CH04245HPILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310101/01/2024  
CH042450PILLPACK LLCAMAZON PHARMACY #005 20416 72ND AVE S
KENTWA98032-231910/01/2024 12/31/2024
CH042450PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514604/13/2022  
CH04245EPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514601/01/2024  
CH04245HPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514601/01/2024  
CH042450PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523304/13/2022  
CH042450PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920304/13/2022  
CH042450PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULUHI9681304/13/2022  
CH04245EPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523301/01/2024  
CH04245EPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920301/01/2024  
CH04245EPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULUHI9681301/01/2024  
CH04245HPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523301/01/2024  
CH04245HPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920301/01/2024  
CH04245HPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULUHI9681301/01/2024  
CH04245QPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULUHI9681301/01/2024  
CH042450WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738601/01/2018 07/01/2021
CH042450WAL-MART PHARMACY 10-02871801 HIGHWAY 78 EAST
JASPERAL3550107/01/2014 07/01/2021
CH042450WAL-MART PHARMACY 10-07151501 SKYLAND BLVD EAST
TUSCALOOSAAL3540510/12/2012 07/01/2021
CH042450WAL-MART PHARMACY 10-23065710 MCFARLAND BLVD
NORTHPORTAL3547607/01/2014 07/01/2021
CH042450WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283701/01/2018 07/01/2021
CH042450WALGREEN CODBA: WALGREENS #11404 4400 UNIVERSITY BLVD E
TUSCALOOSAAL35404-510409/20/2012  
CH042450WALGREEN CODBA: WALGREENS #11450 879 HIGHWAY 78
SUMITONAL3514804/01/2015  
CH04245ZWALGREEN CODBA: WALGREENS #11404 4400 UNIVERSITY BLVD E
TUSCALOOSAAL35404-510404/01/2017 04/01/2019
CH04245HWALGREEN CODBA: WALGREENS #11404 4400 UNIVERSITY BLVD E
TUSCALOOSAAL35404-510401/01/2024  
CH04245IWALGREEN CODBA: WALGREENS #11450 879 HIGHWAY 78
SUMITONAL3514801/01/2024  
CH04245AAWALGREEN CODBA: WALGREENS #11450 879 HIGHWAY 78
SUMITONAL3514801/01/2024 01/01/2025
CH04245EWALGREEN CODBA: WALGREENS #11404 4400 UNIVERSITY BLVD E
TUSCALOOSAAL35404-510401/01/2024  
CH04245EWALGREEN CODBA: WALGREENS #11450 879 HIGHWAY 78
SUMITONAL3514801/01/2024  
CH04245HWALGREEN CODBA: WALGREENS #11450 879 HIGHWAY 78
SUMITONAL3514801/01/2024  
CH04245IWALGREEN CODBA: WALGREENS #11404 4400 UNIVERSITY BLVD E
TUSCALOOSAAL35404-510401/01/2024  
CH04245QWALGREEN CODBA: WALGREENS #11404 4400 UNIVERSITY BLVD E
TUSCALOOSAAL35404-510401/01/2024  
CH04245QWALGREEN CODBA: WALGREENS #11450 879 HIGHWAY 78
SUMITONAL3514801/01/2024  
CH04245SWALGREEN CODBA: WALGREENS #11404 4400 UNIVERSITY BLVD E
TUSCALOOSAAL35404-510401/01/2024  
CH04245RWALGREEN CODBA: WALGREENS #11404 4400 UNIVERSITY BLVD E
TUSCALOOSAAL35404-510401/01/2024  
CH04245RWALGREEN CODBA: WALGREENS #11450 879 HIGHWAY 78
SUMITONAL3514801/01/2024  
CH04245ADWALGREEN CODBA: WALGREENS #11404 4400 UNIVERSITY BLVD E
TUSCALOOSAAL35404-510401/01/2024  
CH04245ADWALGREEN CODBA: WALGREENS #11450 879 HIGHWAY 78
SUMITONAL3514801/01/2024  
CH04245WWALGREEN CODBA: WALGREENS #11404 4400 UNIVERSITY BLVD E
TUSCALOOSAAL35404-510401/01/2024  
CH042450WALGREEN CO.DBA: WALGREENS # 05861 3107 LURLEEN B WALLACE BLVD
NORTHPORTAL3547609/20/2012  
CH042450WALGREEN CO.DBA: WALGREENS # 09683 100 N AIRPORT RD
JASPERAL35504-752009/20/2012  
CH042450WALGREEN CO.DBA: WALGREENS # 10525 8701 HIGHWAY 69 S
TUSCALOOSAAL35405-846509/20/2012  
CH042450WALGREEN CO.DBA: WALGREENS #15451 2731 MARTIN LUTHER KING BLVD
SUITE C
TUSCALOOSAAL3540109/20/2012 06/08/2022
CH042450WALGREEN CO.JIM MYERS A WALGREENS PHARMACY #15448 3325 UNIVERSITY BLVD EAST
TUSCALOOSAAL3540404/01/2015 06/20/2019
CH04245AAWALGREEN CO.DBA: WALGREENS # 09683 100 N AIRPORT RD
JASPERAL35504-752004/01/2017 03/13/2020
CH04245YWALGREEN CO.DBA: WALGREENS #15451 2731 MARTIN LUTHER KING BLVD
SUITE C
TUSCALOOSAAL3540104/01/2017 10/01/2018
CH04245WWALGREEN CO.DBA: WALGREENS #15451 2731 MARTIN LUTHER KING BLVD
SUITE C
TUSCALOOSAAL3540104/01/2017 03/25/2020
CH04245VWALGREEN CO.DBA: WALGREENS #15451 2731 MARTIN LUTHER KING BLVD
SUITE C
TUSCALOOSAAL3540104/01/2017 03/25/2020
CH04245UWALGREEN CO.DBA: WALGREENS #15451 2731 MARTIN LUTHER KING BLVD
SUITE C
TUSCALOOSAAL3540104/01/2017 03/25/2020
CH042450WALGREEN CO.DBA: WALGREENS #15450 701 UNIVERSITY BLVD E M-04
TUSCALOOSAAL3540104/01/2018 09/27/2019
CH042450WALGREEN CO.WALGREENS #17955 3206 15TH ST
TUSCALOOSAAL35401-400210/01/2019 01/29/2025
CH042450WALGREEN CO.WALGREENS #18125 4200 MCFARLAND BLVD E STE 6
TUSCALOOSAAL3540501/01/2020 03/25/2025
CH042450WALGREEN CO.WALGREENS #19553 2916 UNIVERSITY BLVD E
TUSCALOOSAAL35404-424601/01/2020 11/10/2022
CH042450WALGREEN CO.DBA: WALGREENS # 02676 1728 HIGHWAY 45 NORTH
COLUMBUSMS3970504/01/2020  
CH042450WALGREEN CO.JIM MYERS A WALGREENS PHARMACY #15449 1520 MCFARLAND BLVD N
SUITE B
TUSCALOOSAAL3540604/01/2020  
CH042450WALGREEN CO.WALGREENS #18116 521 UNIVERSITY BLVD E
TUSCALOOSAAL35401-202304/01/2020  
CH042450WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16371 3686 GRANDVIEW PKWY STE 120
BIRMINGHAMAL3524307/01/2022  
CH04245HWALGREEN CO.DBA: WALGREENS # 02676 1728 HIGHWAY 45 NORTH
COLUMBUSMS3970501/01/2024  
CH04245HWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16371 3686 GRANDVIEW PKWY STE 120
BIRMINGHAMAL3524301/01/2024  
CH04245HWALGREEN CO.WALGREENS #18116 521 UNIVERSITY BLVD E
TUSCALOOSAAL35401-202301/01/2024  
CH04245HWALGREEN CO.JIM MYERS A WALGREENS PHARMACY #15449 1520 MCFARLAND BLVD N
SUITE B
TUSCALOOSAAL3540601/01/2024  
CH04245HWALGREEN CO.WALGREENS #18125 4200 MCFARLAND BLVD E STE 6
TUSCALOOSAAL3540501/01/2024  
CH04245HWALGREEN CO.WALGREENS #17955 3206 15TH ST
TUSCALOOSAAL35401-400201/01/2024  
CH04245HWALGREEN CO.DBA: WALGREENS # 10525 8701 HIGHWAY 69 S
TUSCALOOSAAL35405-846501/01/2024  
CH04245HWALGREEN CO.DBA: WALGREENS # 05861 3107 LURLEEN B WALLACE BLVD
NORTHPORTAL3547601/01/2024  
CH04245IWALGREEN CO.JIM MYERS A WALGREENS PHARMACY #15449 1520 MCFARLAND BLVD N
SUITE B
TUSCALOOSAAL3540601/01/2024  
CH04245IWALGREEN CO.WALGREENS #17955 3206 15TH ST
TUSCALOOSAAL35401-400201/01/2024  
CH04245IWALGREEN CO.DBA: WALGREENS # 09683 100 N AIRPORT RD
JASPERAL35504-752001/01/2024  
CH04245SWALGREEN CO.DBA: WALGREENS # 10525 8701 HIGHWAY 69 S
TUSCALOOSAAL35405-846501/01/2024  
CH04245RWALGREEN CO.JIM MYERS A WALGREENS PHARMACY #15449 1520 MCFARLAND BLVD N
SUITE B
TUSCALOOSAAL3540601/01/2024  
CH04245XWALGREEN CO.JIM MYERS A WALGREENS PHARMACY #15449 1520 MCFARLAND BLVD N
SUITE B
TUSCALOOSAAL3540601/01/2024  
CH04245RWALGREEN CO.DBA: WALGREENS # 05861 3107 LURLEEN B WALLACE BLVD
NORTHPORTAL3547601/01/2024  
CH04245EWALGREEN CO.DBA: WALGREENS # 05861 3107 LURLEEN B WALLACE BLVD
NORTHPORTAL3547601/01/2024  
CH04245EWALGREEN CO.DBA: WALGREENS # 09683 100 N AIRPORT RD
JASPERAL35504-752001/01/2024  
CH04245EWALGREEN CO.DBA: WALGREENS # 10525 8701 HIGHWAY 69 S
TUSCALOOSAAL35405-846501/01/2024  
CH04245EWALGREEN CO.WALGREENS #17955 3206 15TH ST
TUSCALOOSAAL35401-400201/01/2024  
CH04245EWALGREEN CO.DBA: WALGREENS # 02676 1728 HIGHWAY 45 NORTH
COLUMBUSMS3970501/01/2024  
CH04245EWALGREEN CO.JIM MYERS A WALGREENS PHARMACY #15449 1520 MCFARLAND BLVD N
SUITE B
TUSCALOOSAAL3540601/01/2024  
CH04245EWALGREEN CO.WALGREENS #18116 521 UNIVERSITY BLVD E
TUSCALOOSAAL35401-202301/01/2024  
CH04245EWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16371 3686 GRANDVIEW PKWY STE 120
BIRMINGHAMAL3524301/01/2024  
CH04245HWALGREEN CO.DBA: WALGREENS # 09683 100 N AIRPORT RD
JASPERAL35504-752001/01/2024  
CH04245IWALGREEN CO.DBA: WALGREENS # 05861 3107 LURLEEN B WALLACE BLVD
NORTHPORTAL3547601/01/2024  
CH04245IWALGREEN CO.DBA: WALGREENS # 10525 8701 HIGHWAY 69 S
TUSCALOOSAAL35405-846501/01/2024  
CH04245IWALGREEN CO.WALGREENS #18125 4200 MCFARLAND BLVD E STE 6
TUSCALOOSAAL3540501/01/2024  
CH04245IWALGREEN CO.DBA: WALGREENS # 02676 1728 HIGHWAY 45 NORTH
COLUMBUSMS3970501/01/2024  
CH04245IWALGREEN CO.WALGREENS #18116 521 UNIVERSITY BLVD E
TUSCALOOSAAL35401-202301/01/2024  
CH04245IWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16371 3686 GRANDVIEW PKWY STE 120
BIRMINGHAMAL3524301/01/2024  
CH04245QWALGREEN CO.DBA: WALGREENS # 05861 3107 LURLEEN B WALLACE BLVD
NORTHPORTAL3547601/01/2024  
CH04245QWALGREEN CO.DBA: WALGREENS # 09683 100 N AIRPORT RD
JASPERAL35504-752001/01/2024  
CH04245QWALGREEN CO.DBA: WALGREENS # 10525 8701 HIGHWAY 69 S
TUSCALOOSAAL35405-846501/01/2024  
CH04245QWALGREEN CO.WALGREENS #17955 3206 15TH ST
TUSCALOOSAAL35401-400201/01/2024  
CH04245QWALGREEN CO.WALGREENS #18125 4200 MCFARLAND BLVD E STE 6
TUSCALOOSAAL3540501/01/2024  
CH04245QWALGREEN CO.DBA: WALGREENS # 02676 1728 HIGHWAY 45 NORTH
COLUMBUSMS3970501/01/2024  
CH04245QWALGREEN CO.JIM MYERS A WALGREENS PHARMACY #15449 1520 MCFARLAND BLVD N
SUITE B
TUSCALOOSAAL3540601/01/2024  
CH04245QWALGREEN CO.WALGREENS #18116 521 UNIVERSITY BLVD E
TUSCALOOSAAL35401-202301/01/2024  
CH04245QWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16371 3686 GRANDVIEW PKWY STE 120
BIRMINGHAMAL3524301/01/2024  
CH04245RWALGREEN CO.DBA: WALGREENS # 09683 100 N AIRPORT RD
JASPERAL35504-752001/01/2024  
CH04245RWALGREEN CO.DBA: WALGREENS # 10525 8701 HIGHWAY 69 S
TUSCALOOSAAL35405-846501/01/2024  
CH04245RWALGREEN CO.WALGREENS #17955 3206 15TH ST
TUSCALOOSAAL35401-400201/01/2024  
CH04245RWALGREEN CO.WALGREENS #18125 4200 MCFARLAND BLVD E STE 6
TUSCALOOSAAL3540501/01/2024  
CH04245RWALGREEN CO.DBA: WALGREENS # 02676 1728 HIGHWAY 45 NORTH
COLUMBUSMS3970501/01/2024  
CH04245RWALGREEN CO.WALGREENS #18116 521 UNIVERSITY BLVD E
TUSCALOOSAAL35401-202301/01/2024  
CH04245RWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16371 3686 GRANDVIEW PKWY STE 120
BIRMINGHAMAL3524301/01/2024  
CH04245ADWALGREEN CO.DBA: WALGREENS # 05861 3107 LURLEEN B WALLACE BLVD
NORTHPORTAL3547601/01/2024  
CH04245ADWALGREEN CO.DBA: WALGREENS # 09683 100 N AIRPORT RD
JASPERAL35504-752001/01/2024  
CH04245ADWALGREEN CO.DBA: WALGREENS # 10525 8701 HIGHWAY 69 S
TUSCALOOSAAL35405-846501/01/2024  
CH04245ADWALGREEN CO.WALGREENS #17955 3206 15TH ST
TUSCALOOSAAL35401-400201/01/2024  
CH04245ADWALGREEN CO.WALGREENS #18125 4200 MCFARLAND BLVD E STE 6
TUSCALOOSAAL3540501/01/2024  
CH04245ADWALGREEN CO.DBA: WALGREENS # 02676 1728 HIGHWAY 45 NORTH
COLUMBUSMS3970501/01/2024  
CH04245ADWALGREEN CO.WALGREENS #18116 521 UNIVERSITY BLVD E
TUSCALOOSAAL35401-202301/01/2024  
CH04245ADWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16371 3686 GRANDVIEW PKWY STE 120
BIRMINGHAMAL3524301/01/2024  
CH04245WWALGREEN CO.DBA: WALGREENS # 05861 3107 LURLEEN B WALLACE BLVD
NORTHPORTAL3547601/01/2024  
CH04245WWALGREEN CO.WALGREENS #17955 3206 15TH ST
TUSCALOOSAAL35401-400201/01/2024  
CH04245WWALGREEN CO.WALGREENS #18125 4200 MCFARLAND BLVD E STE 6
TUSCALOOSAAL3540501/01/2024  
CH04245WWALGREEN CO.DBA: WALGREENS # 02676 1728 HIGHWAY 45 NORTH
COLUMBUSMS3970501/01/2024  
CH042450Walgreens #21389Walgreens Central Fill #21389 3299 Tchulatech Dr
Suite 101
MemphisTN3811801/01/2023  
CH04245HWalgreens #21389Walgreens Central Fill #21389 3299 Tchulatech Dr
Suite 101
MemphisTN3811801/01/2024  
CH04245EWalgreens #21389Walgreens Central Fill #21389 3299 Tchulatech Dr
Suite 101
MemphisTN3811801/01/2024  
CH04245IWalgreens #21389Walgreens Central Fill #21389 3299 Tchulatech Dr
Suite 101
MemphisTN3811801/01/2024  
CH04245QWalgreens #21389Walgreens Central Fill #21389 3299 Tchulatech Dr
Suite 101
MemphisTN3811801/01/2024  
CH04245RWalgreens #21389Walgreens Central Fill #21389 3299 Tchulatech Dr
Suite 101
MemphisTN3811801/01/2024  
CH04245ADWalgreens #21389Walgreens Central Fill #21389 3299 Tchulatech Dr
Suite 101
MemphisTN3811801/01/2024  
CH04245XWALMART PHARMACY #10-52481660 MCFARLAND BOULEVARD
NORTHPORTAL3547604/01/2017 05/15/2019
CH042450WINN DIXIE #4074205 UNIVERSITY BLVD EAST
TUSCALOOSAAL3540404/01/2016 07/01/2021
CH042450WINN-DIXIEDBA WINN-DIXIE PHARMACY #528 10 MCFARLAND BLVD
NORTHPORTAL3547604/01/2016 01/15/2020
CH042450WINN-DIXIE PHARMACY #4799750 HIGHWAY 69 SOUTH
TUSCALOOSAAL3540501/01/2013 01/15/2020
CH04245EWINN-DIXIE PHARMACY #4799750 HIGHWAY 69 SOUTH
TUSCALOOSAAL3540501/01/2013 01/15/2020
CH04245JWINN-DIXIE PHARMACY #4799750 HIGHWAY 69 SOUTH
TUSCALOOSAAL3540501/01/2013 01/01/2019
CH04245HWINN-DIXIE PHARMACY #4799750 HIGHWAY 69 SOUTH
TUSCALOOSAAL3540501/01/2013 03/25/2020
CH04245FWINN-DIXIE PHARMACY #4799750 HIGHWAY 69 SOUTH
TUSCALOOSAAL3540501/01/2013 01/01/2019
CH04245IWINN-DIXIE PHARMACY #4799750 HIGHWAY 69 SOUTH
TUSCALOOSAAL3540501/01/2013 03/25/2020
CH04245GWINN-DIXIE PHARMACY #4799750 HIGHWAY 69 SOUTH
TUSCALOOSAAL3540501/01/2013 04/01/2016
CH04245CWINN-DIXIE PHARMACY #4799750 HIGHWAY 69 SOUTH
TUSCALOOSAAL3540501/01/2013 03/25/2020
CH04245QWINN-DIXIE PHARMACY #4799750 HIGHWAY 69 SOUTH
TUSCALOOSAAL3540501/01/2013 03/25/2020
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/1/2024 2:03:41 PM2/10/2025 5:03:25 PM2/10/2025 5:03 PM
ContactsPrimary ContactUpdateProfile Change RequestSherman, Rajuan Fiscal Manager Whatley Health Services 2056146070Sherman, Rajuan Chief Financial Officer Whatley Health Services 20561460702/12/2024 12:07 PM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False2/1/2024 2:03 PM
Medicaid BillingMedicaid: NumberInsertRecertification 3122572/1/2024 2:03 PM
Medicaid BillingMedicaid: StateInsertRecertification AL2/1/2024 2:03 PM
DetailsLast Recertification DateUpdateRecertification 2/1/2024 2:03:41 PM2/1/2024 2:03 PM
DetailsStateUpdate ApprovedActive1/1/2024 12:01 AM
ContactsSigned ByInsertNew Registration Gay, David CEO Whatley Health Services 205614613510/6/2023 3:19 PM
Details340B IDUpdateNew Registration CH04245AD10/6/2023 3:19 PM
DatesParticipating Approval DateUpdateNew Registration 10/6/2023 3:19:24 PM10/6/2023 3:19 PM
DetailsStateUpdateNew RegistrationPendingApproved10/6/2023 3:19 PM
DatesSigned By DateUpdateNew Registration 10/6/2023 1:22:48 PM10/6/2023 3:19 PM
DatesStart DateUpdateNew Registration 1/1/2024 12:00:00 AM10/6/2023 3:19 PM
AddressesMain AddressInsertNew Registration  432 5th St NW Aliceville, AL 3544210/6/2023 1:22 PM
AddressesBilling AddressInsertNew Registration Whatley Health Services, Inc. P.O. Box 2400 Tuscaloosa, AL 35403-240010/6/2023 1:22 PM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False10/6/2023 1:22 PM
Medicaid BillingMedicaid: NumberInsertNew Registration 63000000510/6/2023 1:22 PM
Medicaid BillingMedicaid: StateInsertNew Registration AL10/6/2023 1:22 PM
Medicaid BillingNPI: NumberInsertNew Registration 106342275610/6/2023 1:22 PM
Medicaid BillingNPI: StateInsertNew Registration AL10/6/2023 1:22 PM
Medicaid BillingNPI: NumberInsertNew Registration 129544778710/6/2023 1:22 PM
Medicaid BillingNPI: StateInsertNew Registration AL10/6/2023 1:22 PM
ContactsAuthorizing OfficialInsertNew Registration Gay, David CEO Whatley Health Services 205614613510/6/2023 1:22 PM
ContactsPrimary ContactInsertNew Registration Sherman, Rajuan Fiscal Manager Whatley Health Services 205614607010/6/2023 1:22 PM
DetailsAssistance Received From DateInsertNew Registration  10/6/2023 1:22 PM
DetailsAssistance Received To DateInsertNew Registration  10/6/2023 1:22 PM
DetailsLast Recertification DateInsertNew Registration  10/6/2023 1:22 PM
DetailsGrant NumberInsertNew Registration H80CS0009410/6/2023 1:22 PM
Details340B IDInsertNew Registration  10/6/2023 1:22 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  10/6/2023 1:22 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  10/6/2023 1:22 PM
DetailsMedicare Provider NumberInsertNew Registration  10/6/2023 1:22 PM
DetailsEntity NameInsertNew Registration WHATLEY HEALTH SERVICES INC10/6/2023 1:22 PM
DetailsNOFO NumberInsertNew Registration  10/6/2023 1:22 PM
DetailsProgram CodeInsertNew Registration CH10/6/2023 1:22 PM
DetailsEntity SubnameInsertNew Registration Whatley Health Services at Aliceville10/6/2023 1:22 PM
DatesParticipating Approval DateInsertNew Registration  10/6/2023 1:22 PM
DetailsStateInsertNew Registration Pending10/6/2023 1:22 PM
DatesRegistration DateInsertNew Registration 10/6/2023 1:22:44 PM10/6/2023 1:22 PM
DatesSigned By DateInsertNew Registration  10/6/2023 1:22 PM
DatesStart DateInsertNew Registration  10/6/2023 1:22 PM
TerminationsTermination CommentsInsertNew Registration  10/6/2023 1:22 PM
TerminationsTermination DateInsertNew Registration  10/6/2023 1:22 PM
TerminationsTermination Effective DateInsertNew Registration  10/6/2023 1:22 PM
TerminationsTermination ReasonInsertNew Registration  10/6/2023 1:22 PM