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WHITAKER DRUGS
FQHCLA429 Physicians Care of Clarke
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Covered Entity Details
Entity Name
Physicians Care of Clarke
Subdivision Name
Fulton Family Medical
Type
Health Center Program Look-Alike
340B ID
FQHCLA429
Entity Address
218 Main St
Fulton, AL 36446-0065
Grant Number
LALCS43504
Participating Start Date
1/1/2022
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WHITAKER DRUGS
Pharmacy Address
20 CAMDEN BYP
CAMDEN, AL 36726
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
FARRELL A TURNER, CEO
(256) 201-0095
Contract Pharmacy Representative
Whitaker Drugs
Chip Whitaker, Owner
(334) 682-9990
Signed By Date
10/14/2021
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