Contract Pharmacy Details

WALGREEN CO.
CH04245W WHATLEY HEALTH SERVICES, INC.

Covered Entity Details

Entity Name

WHATLEY HEALTH SERVICES, INC.

Subdivision Name

Theodore Hendrix Dental Center

Type

HRSA-Funded Health Center

340B ID

CH04245W

Entity Address

2731 Martin L. King, Jr., Blvd.
Tuscaloosa, AL 35401

Grant Number

H80CS00094

Participating Start Date

4/1/2017

Last Recertification Date

2/10/2025

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

3/25/2020
Agreement registered in error

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Walgreens
Edwin Raff, DVP Contracting & Pricing
(847) 964-6198

Signed By Date

340B Drug Pricing Program Database