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WALMART PHARMACY 10-5169
STD35233 BIRMINGHAM AIDS OUTREACH INC.
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Covered Entity Details
Entity Name
BIRMINGHAM AIDS OUTREACH INC.
Subdivision Name
Magic City Wellness Center
Type
Sexually Transmitted Diseases
340B ID
STD35233
Entity Address
3220 5th Avenue South
Suite 100
Birmingham, AL 35222
Grant Number
5 NH25PS005129-04
Participating Start Date
1/1/2017
Last Recertification Date
5/10/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
Pharmacy Comments
Contract Details
Approval Date
1/4/2023
Contract Begin Date
1/30/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KAREN MUSGROVE, EXECUTIVE DIRECTOR
(205) 322-4197
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/4/2023
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