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WALGREEN CO.
CH04245Y WHATLEY HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
WHATLEY HEALTH SERVICES, INC.
Subdivision Name
Stillman Health Center
Type
HRSA-Funded Health Center
340B ID
CH04245Y
Entity Address
3601 STILLMAN BLVD
TUSCALOOSA, AL 35401-2601
Grant Number
H80CS00094
Participating Start Date
4/1/2017
Last Recertification Date
2/19/2018
Entity Termination Date
10/1/2018
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #15451
2731 MARTIN LUTHER KING BLVD
SUITE C
TUSCALOOSA, AL 35401
Pharmacy Comments
Contract Details
Approval Date
1/18/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Walgreens
Edwin Raff, DVP Contracting & Pricing
(847) 964-6198
Signed By Date
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