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WALMART PHARMACY #10-5925
HV358011A AIDS Action Coalition of Huntsville
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Covered Entity Details
Entity Name
AIDS Action Coalition of Huntsville
Subdivision Name
Thrive Alabama
Type
Ryan White Part C
340B ID
HV358011A
Entity Address
112 S. Pine Street
Florence, AL 35630
Grant Number
H76HA00624
Participating Start Date
1/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY #10-5925
Pharmacy Address
2305 JORDAN LN SW
HUNTSVILLE, AL 35805
Pharmacy Comments
Contract Details
Approval Date
1/9/2025
Contract Begin Date
1/15/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/10/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mary Elizabeth Marr, CEO
(256) 337-8283
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/9/2025
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