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ALABAMA CVS PHARMACY, L.L.C.
RWII354011D West Alabama AIDS Outreach
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Covered Entity Details
Entity Name
West Alabama AIDS Outreach
Subdivision Name
Five Horizons Health Services - Dothan
Type
Ryan White Part B
340B ID
RWII354011D
Entity Address
1891 Honeysuckle Road
Suite 2
Dothan, AL 36305
Grant Number
X07HA00049
Participating Start Date
3/13/2023
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
ALABAMA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04858
100 US HWY 231
TROY, AL 36081
Pharmacy Comments
Contract Details
Approval Date
10/14/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Will Rainer, Chief Compliance Officer
(659) 734-2319
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/14/2024
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