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Walmart Pharmacy 10-7611
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 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/3/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
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
10/3/2023
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