Contract Pharmacy Details

TENNESSEE CVS PHARMACY, L.L.C.
RWII37404A Positively Living Inc.

Covered Entity Details

Entity Name

Positively Living Inc.

Subdivision Name

Type

Ryan White Part B

340B ID

RWII37404A

Entity Address

1331 Union Ave
1240
Memphis, TN 38104

Grant Number

X07HA00024

Participating Start Date

1/1/2021

Last Recertification Date

3/4/2025

Pharmacy Details

Pharmacy Name

TENNESSEE CVS PHARMACY, L.L.C.

Pharmacy Address

DBA CVS/PHARMACY #10204
4155 ELVIS PRESLEY BLVD
MEMPHIS, TN 38116

Pharmacy Comments

Contract Details

Approval Date

1/15/2021

Contract Begin Date

4/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Steve Jenkins, Chief Executive Officer
(865) 556-5217

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

1/15/2021

340B Drug Pricing Program Database