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TENNESSEE CVS PHARMACY, L.L.C.
STD381043 Positively Living
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Covered Entity Details
Entity Name
Positively Living
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD381043
Entity Address
1331 Union Avenue
750H
Memphis, TN 38104
Grant Number
6NU65PS923764-01-01
Participating Start Date
10/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
TENNESSEE CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 6304
6116 QUINCE RD
MEMPHIS, TN 38119
Pharmacy Comments
Contract Details
Approval Date
10/14/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Steve Jenkins, Chief Executive Officer
(865) 556-5217
Contract Pharmacy Representative
CVSHEALTH
ADAM J HORN, ACCOUNT MGR
(773) 610-9315
Signed By Date
10/14/2024
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