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WINN DIXIE MONTGOMERY, LLC.
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
WINN DIXIE MONTGOMERY, LLC.
Pharmacy Address
WINN DIXIE PHARMACY # 428
5326 HWY 231 SOUTH
WETUMPKA, AL 36092
Pharmacy Comments
Contract Details
Approval Date
1/19/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bernell Mapp, Chief Executive Officer
(334) 420-5001
Contract Pharmacy Representative
John Fegan, VP of Pharmacy
(904) 783-5000
Signed By Date
1/19/2016
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