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WAL-MART PHARMACY 10-5616
RWII37204 Nashville CARES
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Covered Entity Details
Entity Name
Nashville CARES
Subdivision Name
Type
Ryan White Part B
340B ID
RWII37204
Entity Address
442 Metroplex Dr.
Building D Suite 100
Nashville, TN 37211
Grant Number
X07HA00024
Participating Start Date
4/23/2021
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5616
Pharmacy Address
2421 POWELL AVE
NASHVILLE, TN 37204
Pharmacy Comments
Contract Details
Approval Date
4/23/2021
Contract Begin Date
4/23/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Amna Osman, CEO
(615) 762-6953
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/15/2021
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