Covered Entity Details

STD857131 Pima County Juvenile Detention Center (Active) - information as of 4/29/2025 11:51:07 PM

Main Details

Name

Pima County Juvenile Detention Center

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD857131

Grant Number

NU51PS005142

Nature of Support
Please Describe the “in-kind” Support
Time period section 318 funding or in-kind support was received

In-Kind products or services (see note below; must have been purchased with section 318 funds)
Note: In-kind contributions may be in the form of real property, equipment, supplies and other expendable property, and goods and services directly benefiting and specifically identifiable to the project or program.
testing supplies, health education information, databases, care coordination
5/1/2023 - 4/30/2025

Additional Details

Current Program Status

Active

Registration Date

7/5/2023

Participating Start Date

10/1/2023

Participating Approval Date

7/20/2023

Last Recertification Date

5/9/2024

Notice of Funding Opportunity (NOFO) Number

PS21-2103

Contacts

Authorizing Official

PCBH
Linda P Everett, Program Manager
(520) 724-7517

Primary Contact

PCBH
Keisha Everett, Program Coordinator
(520) 403-1549

Addresses

Street Address

2225 E Ajo Way
Tucson, AZ 85713

Billing Address

Pima County Behavioral Health Department - Linda Everett
3950 S Country Club Rd
Tucson, AZ 85714

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	NAPHCARE 340B PHARMACY	NAPHCARE PHARMACY, LLC	2086 COLUMBIANA RD STE 1200	VESTAVIA HILLS	AL	35216	07/20/2023	10/01/2023		10/01/2023	12/04/2023

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Nature of Support: Support Received To Date	Update	Recertification	4/30/2024 12:00:00 AM	4/30/2025 12:00:00 AM	5/9/2024 1:30 PM
Details	Last Recertification Date	Update	Recertification		5/9/2024 1:30:06 PM	5/9/2024 1:30 PM
Details	State	Update		Approved	Active	10/1/2023 12:01 AM
Addresses	Billing Address	Insert	Change Request		Pima County Behavioral Health Department - Linda Everett 3950 S Country Club Rd Tucson, AZ 85714	7/26/2023 12:52 PM
Contacts	Signed By	Insert	New Registration		Everett, Linda P Program Manager PCBH 5207247517	7/20/2023 10:08 AM
Details	340B ID	Update	New Registration		STD857131	7/20/2023 10:08 AM
Dates	Participating Approval Date	Update	New Registration		7/20/2023 10:08:36 AM	7/20/2023 10:08 AM
Details	State	Update	New Registration	Pending	Approved	7/20/2023 10:08 AM
Dates	Signed By Date	Update	New Registration		7/5/2023 6:48:20 PM	7/20/2023 10:08 AM
Dates	Start Date	Update	New Registration		10/1/2023 12:00:00 AM	7/20/2023 10:08 AM
Addresses	Main Address	Insert	New Registration		2225 E Ajo Way Tucson, AZ 85713	7/5/2023 6:48 PM
Details	Nature of Support: In Kind Support Description	Insert	New Registration		testing supplies, health education information, databases, care coordination	7/5/2023 6:48 PM
Details	Nature Of Support	Insert	New Registration		In-Kind products or services (see note below; must have been purchased with section 318 funds)	7/5/2023 6:48 PM
Details	Nature of Support: Support Received From Date	Insert	New Registration		5/1/2023 12:00:00 AM	7/5/2023 6:48 PM
Details	Nature of Support: Support Received To Date	Insert	New Registration		4/30/2024 12:00:00 AM	7/5/2023 6:48 PM
Contacts	Authorizing Official	Insert	New Registration		Everett, Linda P Program Manager PCBH 5207247517	7/5/2023 6:48 PM
Contacts	Primary Contact	Insert	New Registration		Everett, Keisha Program Coordinator PCBH 5204031549	7/5/2023 6:48 PM
Details	Assistance Received From Date	Insert	New Registration			7/5/2023 6:48 PM
Details	Assistance Received To Date	Insert	New Registration			7/5/2023 6:48 PM
Details	Last Recertification Date	Insert	New Registration			7/5/2023 6:48 PM
Details	Grant Number	Insert	New Registration		NU51PS005142	7/5/2023 6:48 PM
Details	340B ID	Insert	New Registration			7/5/2023 6:48 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/5/2023 6:48 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/5/2023 6:48 PM
Details	Medicare Provider Number	Insert	New Registration			7/5/2023 6:48 PM
Details	Entity Name	Insert	New Registration		Pima County Juvenile Detention Center	7/5/2023 6:48 PM
Details	NOFO Number	Insert	New Registration		PS21-2103	7/5/2023 6:48 PM
Details	Program Code	Insert	New Registration		STD	7/5/2023 6:48 PM
Details	Entity Subname	Insert	New Registration			7/5/2023 6:48 PM
Dates	Participating Approval Date	Insert	New Registration			7/5/2023 6:48 PM
Details	State	Insert	New Registration		Pending	7/5/2023 6:48 PM
Dates	Registration Date	Insert	New Registration		7/5/2023 6:48:17 PM	7/5/2023 6:48 PM
Dates	Signed By Date	Insert	New Registration			7/5/2023 6:48 PM
Dates	Start Date	Insert	New Registration			7/5/2023 6:48 PM
Terminations	Termination Comments	Insert	New Registration			7/5/2023 6:48 PM
Terminations	Termination Date	Insert	New Registration			7/5/2023 6:48 PM
Terminations	Termination Effective Date	Insert	New Registration			7/5/2023 6:48 PM
Terminations	Termination Reason	Insert	New Registration			7/5/2023 6:48 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History