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TENNESSEE CVS PHARMACY, L.L.C.
CHC24149-06 MERCY HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
MERCY HEALTH SERVICES, INC.
Subdivision Name
Mercy office at Marshall Co Cornersville Elementary
Type
HRSA-Funded Health Center
340B ID
CHC24149-06
Entity Address
485 N Main St
Cornersville, TN 37047-4104
Grant Number
H80CS24149
Participating Start Date
1/1/2025
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
TENNESSEE CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 386
4805 COLUMBIA PIKE
THOMPSON STATION, TN 37179
Pharmacy Comments
Contract Details
Approval Date
11/12/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rhonda Sizemore, CFO
(615) 790-0567 Ext: 206
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
11/7/2024
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