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WHITAKER DRUGS
SCH010102-00 JOHN PAUL JONES HOSPITAL
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Covered Entity Details
Entity Name
JOHN PAUL JONES HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH010102-00
Entity Address
317 MCWILLIAMS AVENUE
CAMDEN, AL 36726-1610
Medicare Provider Number
010102
Participating Start Date
1/1/2019
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
WHITAKER DRUGS
Pharmacy Address
20 CAMDEN BYP
CAMDEN, AL 36726
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Elizabeth M Kennedy, Administrator
(334) 682-4131
Contract Pharmacy Representative
Whitaker Drugs
Chip Whitaker, Owner
(334) 682-9990
Signed By Date
1/15/2019
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