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Walmart Pharmacy 10-7611
CH04571L Northeast Alabama Health Services, Inc.
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Covered Entity Details
Entity Name
Northeast Alabama Health Services, Inc.
Subdivision Name
Northeast Alabama Health Services, Inc. - Woodville
Type
HRSA-Funded Health Center
340B ID
CH04571L
Entity Address
13624 County Road 8
Woodville, AL 35776-6162
Grant Number
H80CS00760
Participating Start Date
10/1/2013
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DEBORAH CULPEPPER, CEO
(256) 259-5313 Ext: 221
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/16/2023
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