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ABBEVILLE PHARMACY
CH04895P SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATE
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Covered Entity Details
Entity Name
SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATE
Subdivision Name
SARHA Mobile Health Center
Type
HRSA-Funded Health Center
340B ID
CH04895P
Entity Address
1412 ELBA HWY
TROY, AL 36079-6020
Grant Number
H80CS00376
Participating Start Date
4/1/2024
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
ABBEVILLE PHARMACY
Pharmacy Address
DBA DALTON PHARMACY
615 OZARK RD STE B
ABBEVILLE, AL 36310-2629
Pharmacy Comments
Contract Details
Approval Date
3/8/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Pamylon Bowers, Chief Executive Officer
(334) 670-6726 Ext: 173
Contract Pharmacy Representative
Dalton Pharmacies
Joe A. Dalton, President & Owner
(334) 797-7992
Signed By Date
1/4/2024
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