| Contacts | Authorizing Official | Update | Group Change Request | Ellis, Robert Lee
Deputy Assistant Director - CFO
Arizona Department of Corrections
6023292260 | Drennan, Holly
Grants Specialist
Arizona Department of Corrections
9284205315 | 4/17/2025 6:17 AM |
| Contacts | Primary Contact | Update | Group Change Request | Drennan, Holly
Grants Specialist
Arizona Department of Corrections
9284205315 | Hollingsworth, Casey
CORRECTIONAL RN
ADCRR
7025210237 | 2/26/2025 7:59 AM |
| Contacts | Primary Contact | Update | Group Change Request | Gann, Larry
Assistant Director
Arizona Department of Corrections, Rehabilitation and Reentry
6022552491 | Drennan, Holly
Grants Specialist
Arizona Department of Corrections
9284205315 | 1/22/2025 11:29 AM |
| Contacts | Primary Contact | Update | Group Change Request | Phillips, Grant
Medical Director
Arizona Department of Corrections, Rehabilitation & Reentry
4802720892 | Gann, Larry
Assistant Director
Arizona Department of Corrections, Rehabilitation and Reentry
6022552491 | 12/30/2024 7:47 AM |
| Details | Last Recertification Date | Update | Recertification | 5/8/2023 5:55:14 PM | 5/11/2024 1:34:27 PM | 5/11/2024 1:34 PM |
| Addresses | Billing Address | Update | Change Request | Arizona Department of Corrections, Rehabilitation & Reentry
1601 W Jefferson St
MC 333
Phoenix, AZ 85007 | Arizona Department of Corrections, Rehabilitation & Reentry
701 E Jefferson St
Phoenix, AZ 85034 | 2/29/2024 7:12 AM |
| Contacts | Primary Contact | Update | Change Request | Drennan, Holly
Grants Manager
ADCRR
9284205315 | Phillips, Grant
Medical Director
Arizona Department of Corrections, Rehabilitation & Reentry
4802720892 | 2/29/2024 7:12 AM |
| Details | Entity Subname | Update | Change Request | ASPC-Florence | ASPC-Eyman South | 2/29/2024 7:12 AM |
| Details | Nature of Support: Support Received To Date | Update | Change Request | 12/31/2023 12:00:00 AM | | 2/6/2024 2:22 PM |
| Details | Nature of Support: Support Received To Date | Update | Recertification | 12/31/2021 12:00:00 AM | 12/31/2023 12:00:00 AM | 5/8/2023 5:55 PM |
| Details | Last Recertification Date | Update | Recertification | 5/13/2022 1:55:50 PM | 5/8/2023 5:55:14 PM | 5/8/2023 5:55 PM |
| Contacts | Authorizing Official | Update | AO Change Request | Murtha, Valerie
Assistant Director, Financial Services Division
AZ Department of Corrections
6024696662 | Ellis, Robert Lee
Deputy Assistant Director - CFO
Arizona Department of Corrections
6023292260 | 5/7/2023 8:17 AM |
| Contacts | Primary Contact | Update | Recertification | Koster, Katherine
Budget Analyst
Arizona Department Of Corrections
6025422337 | Drennan, Holly
Grants Manager
ADCRR
9284205315 | 5/13/2022 1:55 PM |
| Details | Last Recertification Date | Update | Recertification | 5/27/2021 1:15:18 PM | 5/13/2022 1:55:50 PM | 5/13/2022 1:55 PM |
| Details | Nature of Support: Support Received From Date | Update | Recertification | | 1/1/2021 12:00:00 AM | 5/27/2021 1:15 PM |
| Details | Nature of Support: Support Received To Date | Update | Recertification | | 12/31/2021 12:00:00 AM | 5/27/2021 1:15 PM |
| Contacts | Primary Contact | Update | Recertification | Brewer, DeeAnn
Budget and Grants Manager
Arizona Department of Corrections, Rehabilitation and Reentry
6025426067 | Koster, Katherine
Budget Analyst
Arizona Department Of Corrections
6025422337 | 5/27/2021 1:15 PM |
| Details | Last Recertification Date | Update | Recertification | | 5/27/2021 1:15:18 PM | 5/27/2021 1:15 PM |
| Details | NOFO Number | Update | Recertification | | PS19-1901 | 5/27/2021 1:15 PM |
| Contacts | Authorizing Official | Update | AO Change Request | Evitch, Richard
Assistant Director Financial Services
Arizona Department of Corrections, Rehabilitation and Reentry
6025422838 | Murtha, Valerie
Assistant Director, Financial Services Division
AZ Department of Corrections
6024696662 | 5/25/2021 1:36 PM |
| Details | State | Update | | Approved | Active | 7/1/2020 12:00 AM |
| Addresses | Main Address | Insert | New Registration | |
ASPC-Florence
1305 E Butte Ave
Florence, AZ 85132 | 5/6/2020 1:25 PM |
| Addresses | Billing Address | Insert | New Registration | | Arizona Department of Corrections, Rehabilitation & Reentry
1601 W Jefferson St
MC 333
Phoenix, AZ 85007 | 5/6/2020 1:25 PM |
| Contacts | Signed By | Insert | New Registration | | Evitch, Richard
Assistant Director Financial Services
Arizona Department of Corrections, Rehabilitation and Reentry
6025422838 | 5/6/2020 1:25 PM |
| Details | 340B ID | Update | New Registration | | STD851321 | 5/6/2020 1:25 PM |
| Dates | Participating Approval Date | Update | New Registration | | 5/6/2020 1:25:24 PM | 5/6/2020 1:25 PM |
| Details | State | Update | New Registration | Pending | Approved | 5/6/2020 1:25 PM |
| Dates | Signed By Date | Update | New Registration | | 5/1/2020 6:14:57 PM | 5/6/2020 1:25 PM |
| Dates | Start Date | Update | New Registration | | 7/1/2020 12:00:00 AM | 5/6/2020 1:25 PM |
| Addresses | Main Address | Insert | New Registration | |
1601 W Jefferson St.
MC 333
Phoenix, AZ 85007 | 4/5/2020 4:07 PM |
| Addresses | Shipping Address | Insert | New Registration | | ASPC-Florence
1305 E Butte Ave
Florence, AZ 85132 | 4/5/2020 4:07 PM |
| Details | Nature Of Support | Insert | New Registration | | Direct Funding (dollars received from CDC or an intermediate organization) | 4/5/2020 4:07 PM |
| Contacts | Primary Contact | Insert | New Registration | | Brewer, DeeAnn
Budget and Grants Manager
Arizona Department of Corrections, Rehabilitation and Reentry
6025426067 | 4/5/2020 4:07 PM |
| Contacts | Authorizing Official | Insert | New Registration | | Evitch, Richard
Assistant Director Financial Services
Arizona Department of Corrections, Rehabilitation and Reentry
6025422838 | 4/5/2020 4:07 PM |
| Details | Last Recertification Date | Insert | New Registration | | | 4/5/2020 4:07 PM |
| Details | Grant Number | Insert | New Registration | | 6NH25PS005157-02-02 | 4/5/2020 4:07 PM |
| Details | 340B ID | Insert | New Registration | | | 4/5/2020 4:07 PM |
| Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 4/5/2020 4:07 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 4/5/2020 4:07 PM |
| Details | Medicare Provider Number | Insert | New Registration | | | 4/5/2020 4:07 PM |
| Details | Entity Name | Insert | New Registration | | Arizona Department of Corrections, Rehabilitation and Reentry | 4/5/2020 4:07 PM |
| Details | Program Code | Insert | New Registration | | STD | 4/5/2020 4:07 PM |
| Details | Entity Subname | Insert | New Registration | | ASPC-Florence | 4/5/2020 4:07 PM |
| Dates | Participating Approval Date | Insert | New Registration | | | 4/5/2020 4:07 PM |
| Details | State | Insert | New Registration | | Pending | 4/5/2020 4:07 PM |
| Dates | Registration Date | Insert | New Registration | | 4/5/2020 4:07:34 PM | 4/5/2020 4:07 PM |
| Dates | Signed By Date | Insert | New Registration | | | 4/5/2020 4:07 PM |
| Dates | Start Date | Insert | New Registration | | | 4/5/2020 4:07 PM |
| Terminations | Termination Comments | Insert | New Registration | | | 4/5/2020 4:07 PM |
| Terminations | Termination Date | Insert | New Registration | | | 4/5/2020 4:07 PM |
| Terminations | Termination Effective Date | Insert | New Registration | | | 4/5/2020 4:07 PM |
| Terminations | Termination Reason | Insert | New Registration | | | 4/5/2020 4:07 PM |