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WAL-MART PHARMACY 10-0843
CH044150 ALBANY AREA PRIMARY HEALTH CARE, INC
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Covered Entity Details
Entity Name
ALBANY AREA PRIMARY HEALTH CARE, INC
Subdivision Name
ALBANY AREA PRIMARY HEALTH CARE, INC.
Type
HRSA-Funded Health Center
340B ID
CH044150
Entity Address
204 N.WESTOVER BLVD.
ALBANY, GA 31707
Grant Number
H80CS00763
Participating Start Date
4/1/2003
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0843
Pharmacy Address
165 US HWY 19 N
CAMILLA, GA 31730-1412
Pharmacy Comments
Contract Details
Approval Date
1/13/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tary Brown, CEO
(229) 888-6559 Ext: 6204
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/13/2014
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