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WAL-MART PHARMACY 10-1124
CHC33642-02 AIDS Action Coalition of Huntsville
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Covered Entity Details
Entity Name
AIDS Action Coalition of Huntsville
Subdivision Name
Thrive Behavioral Health - Church Street
Type
HRSA-Funded Health Center
340B ID
CHC33642-02
Entity Address
415E Church St NW
Ste 10
Huntsville, AL 35801
Grant Number
H80CS33642
Participating Start Date
1/1/2020
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1124
Pharmacy Address
1201 HIGHWAY 31, N.W.
HARTSELLE, AL 35640
Pharmacy Comments
Contract Details
Approval Date
11/22/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/19/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Mary Elizabeth Marr, CEO
(256) 337-8283
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
11/22/2019
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