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WINN-DIXIE PHARMACY
CH047080 MOBILE COUNTY BOARD OF HEALTH
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Covered Entity Details
Entity Name
MOBILE COUNTY BOARD OF HEALTH
Subdivision Name
FAMILY ORIENTED PRIMARY HEALTH CARE CLIN
Type
HRSA-Funded Health Center
340B ID
CH047080
Entity Address
251 N Bayou St
Mobile, AL 36603-5827
Grant Number
H80CS00318
Participating Start Date
12/1/1992
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WINN-DIXIE PHARMACY
Pharmacy Address
DBA WINN-DIXIE PHARMACY #549
740 N. SCHILLINGER ROAD
MOBILE, AL 36608
Pharmacy Comments
Contract Details
Approval Date
4/16/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/25/2023
Ownership change
Contacts
Covered Entity Signing Official
Angelia Lewis, CEO
(251) 690-8832
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
4/16/2018
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