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BIRMINGHAM APOTHECARY
RW424770A The University of Alabama at Birmingham
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Covered Entity Details
Entity Name
The University of Alabama at Birmingham
Subdivision Name
UAB Family Clinic
Type
Ryan White Part D
340B ID
RW424770A
Entity Address
1500 6th Avenue South
Birmingham, AL 35233
Grant Number
H12HA24770
Participating Start Date
1/1/2024
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
BIRMINGHAM APOTHECARY
Pharmacy Address
1032 20TH ST S
BIRMINGHAM, AL 35205-2606
Pharmacy Comments
Contract Details
Approval Date
1/10/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael A Matthews, Interim Associate Vice President RBO
(205) 996-6120
Contract Pharmacy Representative
Birmingham Apothecary
AJ Patel, Pharmacist
(205) 251-4248
Signed By Date
1/10/2024
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