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WAL-MART PHARMACY 10-0715
CHC24177-00 CAHABA MEDICAL CARE FOUNDATION
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Covered Entity Details
Entity Name
CAHABA MEDICAL CARE FOUNDATION
Subdivision Name
Cahaba Medical Care - Centreville Office
Type
HRSA-Funded Health Center
340B ID
CHC24177-00
Entity Address
405 Belcher St
Centreville, AL 35042-2946
Grant Number
H80CS24177
Participating Start Date
1/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0715
Pharmacy Address
1501 SKYLAND BLVD EAST
TUSCALOOSA, AL 35405
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Waits, CEO
(205) 277-2396
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/15/2020
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