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TENNESSEE CVS PHARMACY, L.L.C.
CHC26598-01 MAURY REGIONAL HOSPITAL
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Covered Entity Details
Entity Name
MAURY REGIONAL HOSPITAL
Subdivision Name
PrimeCare
Type
HRSA-Funded Health Center
340B ID
CHC26598-01
Entity Address
854 W. James M Campbell Blvd.
Suite 301
COLUMBIA, TN 38401-4140
Grant Number
H80CS26598
Participating Start Date
10/1/2015
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
TENNESSEE CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06413
1300 TROTWOOD AVENUE
COLUMBIA, TN 38401
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Martin Chaney, Chief Executive Officer
(931) 380-4008
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/16/2024
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