Contract Pharmacy Details

WINN-DIXIE PHARMACY #479
CH04245C WHATLEY HEALTH SERVICES, INC.

Covered Entity Details

Entity Name

WHATLEY HEALTH SERVICES, INC.

Subdivision Name

JAMES O. ELLIS HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH04245C

Entity Address

3532 GREENSBORO AVE.
TUSCALOOSA, AL 35401

Grant Number

H80CS00094

Participating Start Date

1/1/2008

Last Recertification Date

2/8/2022

Entity Termination Date

7/1/2022

Pharmacy Details

Pharmacy Name

WINN-DIXIE PHARMACY #479

Pharmacy Address

9750 HIGHWAY 69 SOUTH
TUSCALOOSA, AL 35405

Pharmacy Comments

Contract Details

Approval Date

11/29/2012

Contract Begin Date

1/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/25/2020
Agreement registered in error

Contacts

Covered Entity Signing Official

Deborah H. Tucker, CEO
(205) 349-3250

Contract Pharmacy Representative

Curtis Hardin, Director of Pharmacy Managed Care
(864) 430-0906

Signed By Date

10/11/2012

340B Drug Pricing Program Database