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TENNESSEE CVS PHARMACY, L.L.C.
CH04656M Hardin County Regional Health Center
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Covered Entity Details
Entity Name
Hardin County Regional Health Center
Subdivision Name
Lifespan Health Admin
Type
HRSA-Funded Health Center
340B ID
CH04656M
Entity Address
880 Pickwick St UNIT 2
Savannah, TN 38372-3071
Grant Number
H80CS00180
Participating Start Date
4/1/2023
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
TENNESSEE CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 10072
855 WAYNE RD.
SAVANNAH, TN 38372
Pharmacy Comments
Contract Details
Approval Date
3/3/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Y. T. McGinley, CEO
(731) 925-2300 Ext: 8968
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
3/3/2023
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