Contract Pharmacy Details

M.N. PHARMACY LLC
CH080730 METRO COMMUNITY PROVIDER NETWORK, INC.

Covered Entity Details

Entity Name

METRO COMMUNITY PROVIDER NETWORK, INC.

Subdivision Name

STRIDE CHC- Peoria

Type

HRSA-Funded Health Center

340B ID

CH080730

Entity Address

3292 Peoria St
Aurora, CO 80010

Grant Number

H80CS00217

Participating Start Date

12/1/1992

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

M.N. PHARMACY LLC

Pharmacy Address

DBA AMAZON PHARMACY #003
6701 NW 7TH ST., STE. #199
MIAMI, FL 33126

Pharmacy Comments

Contract Details

Approval Date

7/8/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Ben Wiederholt, CEO
(303) 761-1977 Ext: 1103

Contract Pharmacy Representative

PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725

Signed By Date

7/8/2018

340B Drug Pricing Program Database