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RWI20825D Amity Medical Group (Active)
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Main Details
Name
Amity Medical Group
Subdivision Name
Type
Ryan White Part A
340B ID
RWI20825D
Grant Number
H89HA11434
Additional Details
Current Program Status
Active
Registration Date
10/12/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/31/2023
Last Recertification Date
2/13/2025
Time Period the Assistance was Received
3/1/2023 - 2/28/2026
Contacts
Authorizing Official
Amity Medical Group, Inc
Olivia Bentley, Executive Director
(704) 968-8353
Primary Contact
Amity Medical Group
Amy Kern, Director of Pharmacy
(704) 575-6350
Addresses
Street Address
2300A Randolph Rd 1586
Charlotte, NC 28207
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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