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RWII37604A East Tennessee State University Center of Excellence (Active)
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Main Details
Name
East Tennessee State University Center of Excellence
Subdivision Name
Type
Ryan White Part B
340B ID
RWII37604A
Grant Number
X07HA00024
Additional Details
Current Program Status
Active
Registration Date
4/15/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/23/2024
Last Recertification Date
2/15/2025
Time Period the Assistance was Received
4/1/2024 - 3/31/2025
Contacts
Authorizing Official
East Tennessee State University Center of Excellence
Jonathan Moorman, Director ETSU Center of Excellence
(423) 979-6380
Primary Contact
East Tennessee State University Center of Excellence
Lisa Bynum, Executive Director
(423) 930-8337 Ext: 119
Addresses
Street Address
105 W. Park Drive, Suite 200
Kingsport, TN 37660
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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