340B Drug Pricing Program Database
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MISSISSIPPI CVS PHARMACY, L.L.C.
RWII37404B Positively Living Inc.
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Covered Entity Details
Entity Name
Positively Living Inc.
Subdivision Name
Type
Ryan White Part B
340B ID
RWII37404B
Entity Address
1331 Union Ave
750H
Memphis, TN 38104
Grant Number
X07HA00024
Participating Start Date
1/1/2021
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MISSISSIPPI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08954
7363 GOODMAN RD.
OLIVE BRANCH, MS 38654
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
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