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RWI38104 Friends For Life (Active)
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Main Details
Name
Friends For Life
Subdivision Name
Type
Ryan White Part A
340B ID
RWI38104
Grant Number
H89HA11464
Additional Details
Current Program Status
Active
Registration Date
4/4/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/20/2018
Last Recertification Date
2/20/2025
Time Period the Assistance was Received
3/1/2025 - 2/28/2026
Contacts
Authorizing Official
Friends For Life
Diane Duke, Executive Director
(901) 333-8240
Primary Contact
Friends For Life
Mia Cotton, Director of Client Services
(901) 333-8250
Addresses
Street Address
1548 Poplar Ave
Memphis, TN 38104
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Participating from effective date (4/1/2015) until terminated effective date (4/1/2017), reinstatement date effective date (07/01/2018)
04/11/2018
April 2025
April 2025
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