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WALMART PHARMACY #10-5925
HV358011B AIDS Action Coalition of Huntsville
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Covered Entity Details
Entity Name
AIDS Action Coalition of Huntsville
Subdivision Name
Thrive Alabama
Type
Ryan White Part C
340B ID
HV358011B
Entity Address
201 E. McKinney Ave, Ste A
Albertville, AL 35950
Grant Number
H76HA00624
Participating Start Date
7/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY #10-5925
Pharmacy Address
2305 JORDAN LN SW
HUNTSVILLE, AL 35805
Pharmacy Comments
Contract Details
Approval Date
10/5/2023
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
10/5/2023
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