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WINN-DIXIE PHARMACY #479
CH04245I WHATLEY HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
WHATLEY HEALTH SERVICES, INC.
Subdivision Name
WHATLEY HEALTH SVS @ SIPSEY
Type
HRSA-Funded Health Center
340B ID
CH04245I
Entity Address
3805 SIPSEY ROAD
SIPSEY, AL 35584
Grant Number
H80CS00094
Participating Start Date
7/1/2003
Last Recertification Date
2/10/2025
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
3/25/2020
Agreement registered in error
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
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