Contract Pharmacy Details

WINN-DIXIE PHARMACY #479
CH04245F WHATLEY HEALTH SERVICES, INC.

Covered Entity Details

Entity Name

WHATLEY HEALTH SERVICES, INC.

Subdivision Name

WEST BLOCTON HEALTH CTR

Type

HRSA-Funded Health Center

340B ID

CH04245F

Entity Address

345 MAGNOLIA STREET
WEST BLOCTON, AL 35184

Grant Number

H80CS00094

Participating Start Date

7/1/2003

Last Recertification Date

2/19/2018

Entity Termination Date

1/1/2019

Pharmacy Details

Pharmacy Name

WINN-DIXIE PHARMACY #479

Pharmacy Address

9750 HIGHWAY 69 SOUTH
TUSCALOOSA, AL 35405

Pharmacy Comments

Contract Details

Approval Date

11/29/2012

Contract Begin Date

1/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

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

Contract Pharmacy Representative

Curtis Hardin, Director of Pharmacy Managed Care
(864) 430-0906

Signed By Date

10/11/2012

340B Drug Pricing Program Database