Contract Pharmacy Details

WAL-MART PHARMACY 10-4497
CHC24177-16 Cahaba Medical Care Foundation

Covered Entity Details

Entity Name

Cahaba Medical Care Foundation

Subdivision Name

Cahaba Medical Care - Birmingham Southern

Type

HRSA-Funded Health Center

340B ID

CHC24177-16

Entity Address

900 Arkadelphia Rd Rm 240
Birmingham, AL 35254

Grant Number

H80CS24177

Participating Start Date

1/1/2021

Last Recertification Date

2/2/2024

Entity Termination Date

1/1/2025

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-4497

Pharmacy Address

1007 RED FARMER DRIVE
HUEYTOWN, AL 35023

Pharmacy Comments

Contract Details

Approval Date

10/22/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

John Waits, CEO
(205) 277-2396

Contract Pharmacy Representative

Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498

Signed By Date

10/22/2023

340B Drug Pricing Program Database