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NPS PHARMACY AT ETSU
FQHCLA404 CHATTANOOGA C.A.R.E.S. DBA CEMPA COMMUNITY CARE
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Covered Entity Details
Entity Name
CHATTANOOGA C.A.R.E.S. DBA CEMPA COMMUNITY CARE
Subdivision Name
Cempa Community Care Clinic
Type
Health Center Program Look-Alike
340B ID
FQHCLA404
Entity Address
1000 E. 3rd Street Ste 300
Chattanooga, TN 37403-2153
Grant Number
LALCS33899
Participating Start Date
3/17/2020
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
NPS PHARMACY AT ETSU
Pharmacy Address
615 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604-8209
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shannon Stephenson, CEO
(423) 648-9911
Contract Pharmacy Representative
NPS Pharmacy
Kevin Hartman, Pharm D
(615) 371-1210 Ext: 311
Signed By Date
7/15/2020
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