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PUBLIX ALABAMA, LLC
CH04013J HEALTH SERVICES, (INC)
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Covered Entity Details
Entity Name
HEALTH SERVICES, (INC)
Subdivision Name
Autaugaville Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH04013J
Entity Address
203 N Taylor St
Autaugaville, AL 36003-2663
Grant Number
H80CS00795
Participating Start Date
4/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
PUBLIX ALABAMA, LLC
Pharmacy Address
PUBLIX PHARMACY #1228
2451 COBBS FORD RD.
PRATTVILLE, AL 36066
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
Publix
Amin Mrugesh, 340B Program Manager
(863) 688-1188 Ext: 52388
Signed By Date
10/13/2023
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