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TENNESSEE CVS PHARMACY, L.L.C.
HV01706 MEHARRY MEDICAL COLLEGE
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Covered Entity Details
Entity Name
MEHARRY MEDICAL COLLEGE
Subdivision Name
Type
Ryan White Part C
340B ID
HV01706
Entity Address
1005 DR. B. TODD JR BLVD
NASHVILLE, TN 37208
Grant Number
H76HA01706
Participating Start Date
7/1/2011
Last Recertification Date
3/7/2025
Pharmacy Details
Pharmacy Name
TENNESSEE CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06412
5521 CHARLOTTE AVENUE
NASHVILLE, TN 37209
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/23/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
VLADIMIR BERTHAUD, EXECUTIVE DIRECTOR
(615) 327-5753
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/17/2018
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