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AVITA DRUGS TENNESSEE LLC
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
Entity Address
3309 Cummings Hwy
104
Chattanooga, TN 37206
Grant Number
NH25PS005151
Participating Start Date
Last Recertification Date
Pharmacy Details
Pharmacy Name
AVITA DRUGS TENNESSEE LLC
Pharmacy Address
DBA AVITA PHARMACY 1049
225 S 11TH ST
STE 102
NASHVILLE, TN 37206
Pharmacy Comments
Contract Details
Approval Date
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
PMQ Group, LLC dba Avita
Chris Creamer, SVP
(469) 592-2000
Signed By Date
4/12/2025
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