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KROGER
CH048190 CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.
Subdivision Name
CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH048190
Entity Address
110 Walker Ave NE
Huntsville, AL 35801-4739
Grant Number
H80CS00105
Participating Start Date
12/1/1992
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
KROGER
Pharmacy Address
#517
6070 MOORES MILL ROAD
HUNTSVILLE, AL 35811
Pharmacy Comments
Contract Details
Approval Date
4/15/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/27/2017
Agreement registered in error
Contacts
Covered Entity Signing Official
Carleton H. A. Pyfrom, CEO
(256) 534-8659
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
4/15/2014
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