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ALABAMA CVS PHARMACY, L.L.C.
CHC24177-00 CAHABA MEDICAL CARE FOUNDATION
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Covered Entity Details
Entity Name
CAHABA MEDICAL CARE FOUNDATION
Subdivision Name
Cahaba Medical Care - Centreville Office
Type
HRSA-Funded Health Center
340B ID
CHC24177-00
Entity Address
405 Belcher St
Centreville, AL 35042-2946
Grant Number
H80CS24177
Participating Start Date
1/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
ALABAMA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04897
155 BIRMINGHAM ROAD SUITE 114
CENTREVILLE, AL 35042
Pharmacy Comments
Contract Details
Approval Date
10/12/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John Waits, CEO
(205) 277-2396
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/12/2017
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