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TENNESSEE CVS PHARMACY, L.L.C.
STD372062 Music City PrEP Clinic
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Covered Entity Details
Entity Name
Music City PrEP Clinic
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD372062
Entity Address
3309 Cummings Hwy
104
Chattanooga, TN 37419
Grant Number
NH25PS005151
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
TENNESSEE CVS PHARMACY, L.L.C.
Pharmacy Address
CVS PHARMACY # 16417
7989 US HIGHWAY 64
MEMPHIS, TN 38133
Pharmacy Comments
Contract Details
Approval Date
4/29/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Clark MacKinnon, Executive Director
(615) 469-1065
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/12/2025
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