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WAL-MART PHARMACY 10-0700
CH040130 HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
HEALTH SERVICES, INC.
Subdivision Name
River Region
Type
HRSA-Funded Health Center
340B ID
CH040130
Entity Address
1845 CHERRY STREET
MONTGOMERY, AL 36107
Grant Number
H80CS00795
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0700
Pharmacy Address
1501 HWY 14 EAST
SELMA, AL 36703
Pharmacy Comments
Contract Details
Approval Date
1/9/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bernell C. Mapp, CEO
(334) 265-2454
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/9/2014
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