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WAL-MART PHARMACY # 10-4473
CH090080 MARANA HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
MARANA HEALTH CENTER, INC.
Subdivision Name
Marana Health Center, Inc.
Type
HRSA-Funded Health Center
340B ID
CH090080
Entity Address
13395 N. Marana Main Street
MARANA, AZ 85653
Grant Number
H80CS00231
Participating Start Date
7/1/1999
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY # 10-4473
Pharmacy Address
2175 WEST RUTHRAUFF ROAD
TUCSON, AZ 85705
Pharmacy Comments
Contract Details
Approval Date
7/13/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Greg Redding, Director of Pharmacy
(520) 682-4111
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
7/13/2015
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