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WALMART PHARMACY 10-4672
CH04013H HEALTH SERVICES, (INC)
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Covered Entity Details
Entity Name
HEALTH SERVICES, (INC)
Subdivision Name
Chisholm Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH04013H
Entity Address
100 E Vandiver Blvd
Montgomery, AL 36110-1812
Grant Number
H80CS00795
Participating Start Date
4/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-4672
Pharmacy Address
1600 FEDERAL DRIVE
MONTGOMERY, AL 36109
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gilbert F. Darrington, CEO
(334) 420-5001 Ext: 114
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/13/2023
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