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GIBSON DISCOUNT PHARMACY
CHC24177-00 CAHABA MEDICAL CARE FOUNDATION
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Covered Entity Details
Entity Name
CAHABA MEDICAL CARE FOUNDATION
Subdivision Name
Cahaba Medical Care - Centreville Office
Type
HRSA-Funded Health Center
340B ID
CHC24177-00
Entity Address
405 Belcher St
Centreville, AL 35042-2946
Grant Number
H80CS24177
Participating Start Date
1/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
GIBSON DISCOUNT PHARMACY
Pharmacy Address
1133 LOMB AVE SW
BIRMINGHAM, AL 35211-1246
Pharmacy Comments
Contract Details
Approval Date
10/12/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Waits, CEO
(205) 277-2396
Contract Pharmacy Representative
Gibson Discount Pharmacy
Emily Pinon, Pharm D
(205) 787-4692
Signed By Date
10/12/2018
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