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WINN DIXIE PHARMACY #521
CH040130 HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
HEALTH SERVICES, INC.
Subdivision Name
River Region
Type
HRSA-Funded Health Center
340B ID
CH040130
Entity Address
1845 CHERRY STREET
MONTGOMERY, AL 36107
Grant Number
H80CS00795
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WINN DIXIE PHARMACY #521
Pharmacy Address
3881 ATLANTA HWY
MONTGOMERY, AL 36109
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gilbert F. Darrington, CEO
(334) 420-5001 Ext: 114
Contract Pharmacy Representative
Southeastern Grociers
David Chism, Seinior Director
(904) 370-6455 Ext: 9043706455
Signed By Date
1/12/2018
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