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TENNESSEE CVS PHARMACY, L.L.C.
STD35630 AIDS Action Coalition of Huntsville
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Covered Entity Details
Entity Name
AIDS Action Coalition of Huntsville
Subdivision Name
Thrive Alabama
Type
Sexually Transmitted Diseases
340B ID
STD35630
Entity Address
112 South Pine St
Florence, AL 35630
Grant Number
5 NH25PS005129-05-00
Participating Start Date
4/1/2017
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
TENNESSEE CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06431
2788 MURFREESBORO PIKE
ANTIOCH, TN 37013
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/5/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Mary Elizabeth Marr, CEO
(256) 337-8283
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2020
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