Pharmacy Details

SOUTHEAST MEDICINE SHOP - information as of 4/30/2025 11:00:27 PM

Name
SOUTHEAST MEDICINE SHOP

Address

1108 ROSS CLARK CIRCLE
SUITE 160
DOTHAN, AL 36301

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	DSH010001	SOUTHEAST HEALTH MEDICAL CENTER		Disproportionate Share Hospital	1108 ROSS CLARK CIRCLE		DOTHAN	AL	10/01/2017	01/01/2024	1/1/2024 12:01 AM
Details	DSH010001	SOUTHEAST HEALTH MEDICAL CENTER		Disproportionate Share Hospital	1108 ROSS CLARK CIRCLE		DOTHAN	AL	07/01/2024	10/24/2024	10/30/2024 4:27 PM
Details	DSH010001A	SOUTHEAST HEALTH MEDICAL CENTER	SOUTHEAST HEALTH PAIN MANAGEMENT	Disproportionate Share Hospital	208 HAVEN DRIVE		DOTHAN	AL	07/01/2024	04/01/2025	4/1/2025 12:01 AM
Details	DSH010001B	SOUTHEAST HEALTH MEDICAL CENTER	Southeast Health Wound Care	Disproportionate Share Hospital	1908 Fairview Ave		Dothan	AL	07/01/2024	04/01/2025	4/1/2025 12:01 AM
Details	RRC010001-00	SOUTHEAST HEALTH MEDICAL CENTER		Rural Referral Center	1108 ROSS CLARK CIRCLE		DOTHAN	AL	01/01/2024	07/01/2024	7/1/2024 12:01 AM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			SOUTHEAST MEDICINE SHOP 1108 ROSS CLARK CIRCLE SUITE 160 DOTHAN, AL 36301	9/29/2017 6:44 AM
Details	Comments	Insert				6/2/2017 4:10 PM
Details	Is Deleted	Insert			False	6/2/2017 4:10 PM
Addresses	Pharmacy Address	Insert			SOUTHEAST MEDICINE SHOP 1108 ROSS CLARK CIRCLE SUITE 160 DOTHAN, AL 36301	6/2/2017 4:10 PM
Details	Name	Insert			SOUTHEAST MEDICINE SHOP	6/2/2017 4:10 PM