Contract Pharmacy Details

WINN DIXIE #407
CH042450 WHATLEY HEALTH SERVICES, INC.

Covered Entity Details

Entity Name

WHATLEY HEALTH SERVICES, INC.

Subdivision Name

Maude L. Whatley Health Center

Type

HRSA-Funded Health Center

340B ID

CH042450

Entity Address

2731 MARTIN L KING JR. BLVD.
TUSCALOOSA, AL 35401

Grant Number

H80CS00094

Participating Start Date

1/1/2001

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WINN DIXIE #407

Pharmacy Address

4205 UNIVERSITY BLVD EAST
TUSCALOOSA, AL 35404

Pharmacy Comments

Contract Details

Approval Date

1/15/2016

Contract Begin Date

4/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2021
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Deborah H. Tucker, CEO
(205) 349-3250 Ext: 6135

Contract Pharmacy Representative

John Fegan, VP of Pharmacy
(904) 783-5000

Signed By Date

1/15/2016