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TENNESSEE CVS PHARMACY, L.L.C.
CH041279B RURAL HEALTH SERVICES CONSORTIUM
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Covered Entity Details
Entity Name
RURAL HEALTH SERVICES CONSORTIUM
Subdivision Name
BULLS GAP MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH041279B
Entity Address
260HWY 11-E
BULLS GAP, TN 37711
Grant Number
H80CS00421
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
TENNESSEE CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03489
5674 HWY 11-E SUITE F
PINEY FLATS, TN 37686
Pharmacy Comments
Contract Details
Approval Date
5/3/2023
Contract Begin Date
5/4/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LINDA W. BUCK, CHIEF EXECUTIVE OFFICER
(423) 272-9163 Ext: 8901
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
5/3/2023
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