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CMC PHARMACY CENTREVILLE
RWIID361301 ALABAMA DEPARTMENT OF PUBLIC HEALTH
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Covered Entity Details
Entity Name
ALABAMA DEPARTMENT OF PUBLIC HEALTH
Subdivision Name
HIV AIDS DIVISION
Type
Ryan White Part B ADAP Direct Purchase
340B ID
RWIID361301
Entity Address
201 Monroe Street
Suite 1200
MONTGOMERY, AL 36104
Grant Number
X07HA00049
Participating Start Date
1/1/2004
Last Recertification Date
3/2/2025
Pharmacy Details
Pharmacy Name
CMC PHARMACY CENTREVILLE
Pharmacy Address
405 BELCHER ST
CENTREVILLE, AL 35042
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ronada Anderson, Ryan White Part B Director
(334) 206-7974
Contract Pharmacy Representative
CMC
Sandy Creel, Enrollment Coordinator
(205) 926-2992
Signed By Date
1/15/2025
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