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RWI30311A Heather Ivy Society (Active)
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Main Details
Name
Heather Ivy Society
Subdivision Name
Heather Ivy Society
Type
Ryan White Part A
340B ID
RWI30311A
Grant Number
UT8HA33933
Additional Details
Current Program Status
Active
Registration Date
1/7/2025
Participating Start Date
4/1/2025
Participating Approval Date
2/11/2025
Last Recertification Date
Time Period the Assistance was Received
10/1/2021 - 5/31/2025
Contacts
Authorizing Official
Heather Ivy Society
Zandraetta Tims-Cook, Executive Director
(844) 884-9691 Ext: 1
Primary Contact
Heather Ivy Society
Teresa Pounds, Director of Pharmacy
(404) 718-0689
Addresses
Street Address
381 Forest Parkway
Suite B
Forest Park, GA 30297
Billing Address
Heather Ivy Society
3939 Lavista Road
E-310
Tucker, GA 30084
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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