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ALABAMA CVS PHARMACY, L.L.C.
HV047080 MOBILE COUNTY BOARD OF HEALTH
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Covered Entity Details
Entity Name
MOBILE COUNTY BOARD OF HEALTH
Subdivision Name
RYAN WHITE CLINIC
Type
Ryan White Part C
340B ID
HV047080
Entity Address
251 NORTH BAYOU STREET
MOBILE, AL 36603
Grant Number
H76HA00081
Participating Start Date
12/1/1992
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
ALABAMA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04959
27040 HWY 98
DAPHNE, AL 36526
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kelly R Warren, Executive Director
(251) 690-8832
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2024
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