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WALMART PHARMACY #10-5925
STD35630 AIDS Action Coalition of Huntsville
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Covered Entity Details
Entity Name
AIDS Action Coalition of Huntsville
Subdivision Name
Thrive Alabama
Type
Sexually Transmitted Diseases
340B ID
STD35630
Entity Address
112 South Pine St
Florence, AL 35630
Grant Number
5 NH25PS005129-05-00
Participating Start Date
4/1/2017
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY #10-5925
Pharmacy Address
2305 JORDAN LN SW
HUNTSVILLE, AL 35805
Pharmacy Comments
Contract Details
Approval Date
10/2/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/10/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mary Elizabeth Marr, CEO
(256) 337-8283
Contract Pharmacy Representative
Verity Solutions
Tanner Gard, Community Health Sales Director
(407) 741-5438
Signed By Date
10/2/2023
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