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ALABAMA CVS PHARMACY, L.L.C.
SCH010102-00 JOHN PAUL JONES HOSPITAL
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Covered Entity Details
Entity Name
JOHN PAUL JONES HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH010102-00
Entity Address
317 MCWILLIAMS AVENUE
CAMDEN, AL 36726-1610
Medicare Provider Number
010102
Participating Start Date
1/1/2019
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
ALABAMA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04869
6990 ATLANTA HWY.
MONTGOMERY, AL 36117
Pharmacy Comments
Contract Details
Approval Date
10/2/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Elizabeth M Kennedy, Administrator
(334) 682-4131
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/2/2020
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