340B Drug Pricing Program Database

Name

Prisma Community Care

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD85004

Grant Number

5 NU62PS924676-03-00

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

Direct Funding (dollars received from CDC or an intermediate organization)
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.

7/1/2021 - 6/30/2026

Current Program Status

Active

Registration Date

10/12/2018

Participating Start Date

1/1/2019

Participating Approval Date

12/13/2018

Last Recertification Date

5/8/2024

Notice of Funding Opportunity (NOFO) Number

PS21-2102

Authorizing Official

Prisma Community Care
Jessyca Leach, Chief Executive Officer
(602) 595-8115

Primary Contact

Prisma Community Care
Manny Guilin, Senior Manager, 340B Program & EHR Administrator
(602) 595-8119

Street Address

1101 N Central Ave
Suite 200
Phoenix, AZ 85004

Billing Address
Same as Street Address