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MUSC RUTLEDGE TOWER AMB PHARMACY
RWII29425B Medical University of SC Infectious Disease Ryan White Program
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Covered Entity Details
Entity Name
Medical University of SC Infectious Disease Ryan White Program
Subdivision Name
MUSC Ryan White Program
Type
Ryan White Part B
340B ID
RWII29425B
Entity Address
2250 Mall Dr
North Charleston, SC 29406
Grant Number
X07HA00038
Participating Start Date
10/1/2022
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
MUSC RUTLEDGE TOWER AMB PHARMACY
Pharmacy Address
MARVA WILLIAMS-LOWE, PHARMD
135 RUTLEDGE AVE
RM 106, MSC 584
CHARLESTON, SC 29425
Pharmacy Comments
Contract Details
Approval Date
7/26/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/6/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Richard Lynn Anderson, Executive Vice President for Finance and Operations
(843) 792-5050
Contract Pharmacy Representative
MUSC
Curt Pattee, Pharmacy Director of Operations
(843) 876-5946
Signed By Date
7/14/2022
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