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PARKWAY PHARMACY
RWIID303031 GEORGIA DEPT OF PUBLIC HEALTH
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Covered Entity Details
Entity Name
GEORGIA DEPT OF PUBLIC HEALTH
Subdivision Name
Type
Ryan White Part B ADAP Direct Purchase
340B ID
RWIID303031
Entity Address
200 Piedmont Ave. SE
West Tower
Suite 1508
ATLANTA, GA 30334
Grant Number
X07HA22709
Participating Start Date
4/1/1997
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
PARKWAY PHARMACY
Pharmacy Address
4700 BATTLEFIELD PKWY
SUITE 110
RINGGOLD, GA 30736
Pharmacy Comments
Contract Details
Approval Date
10/14/2010
Contract Begin Date
10/14/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/28/2018
Pharmacy closed
Contacts
Covered Entity Signing Official
MARISOL CRUZ, HIV CARE PROGRAM MANAGER
(404) 463-2453
Contract Pharmacy Representative
Signed By Date
10/1/2010
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