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MISSISSIPPI CVS PHARMACY, L.L.C.
CH0417140 Christ Community Health Services, Inc.
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Covered Entity Details
Entity Name
Christ Community Health Services, Inc.
Subdivision Name
THIRD STREET HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0417140
Entity Address
3362 S 3rd St
MEMPHIS, TN 38109-2944
Grant Number
H80CS00881
Participating Start Date
7/1/2003
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
MISSISSIPPI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08491
2945 GOODMAN ROAD EAST
SOUTHAVEN, MS 38672
Pharmacy Comments
Contract Details
Approval Date
4/23/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/20/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
David Patrick Guy, CFO
(901) 842-3150
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/23/2021
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