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WALMART PHARMACY #10-6878
CHC33642-03 AIDS Action Coalition of Huntsville
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Covered Entity Details
Entity Name
AIDS Action Coalition of Huntsville
Subdivision Name
Thrive Pediatrics
Type
HRSA-Funded Health Center
340B ID
CHC33642-03
Entity Address
3007 Memorial Parkway South
Suite C Unit 2
Huntsville, AL 35801-7420
Grant Number
H80CS33642
Participating Start Date
7/1/2022
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY #10-6878
Pharmacy Address
14595 HWY 231-431 N
HAZEL GREEN, AL 35750
Pharmacy Comments
Contract Details
Approval Date
5/6/2022
Contract Begin Date
5/6/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mary Elizabeth Marr, CEO
(256) 337-8283
Contract Pharmacy Representative
Wellpartner
Jordana Nardiello, Account Manager
(516) 580-1278
Signed By Date
5/6/2022
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