Contract Pharmacy Details

AVELLA OF DEER VALLEY
CH090080 MARANA HEALTH CENTER, INC.

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

AVELLA OF DEER VALLEY

Pharmacy Address

23620 N 20TH DR #12
PHOENIX, AZ 85085-0621

Pharmacy Comments

Contract Details

Approval Date

4/14/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/7/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

Greg Redding, Director of Pharmacy
(520) 682-4111

Contract Pharmacy Representative

Avella
Tammy Sievert, 340B Implementation and Analytics Manager, Corportate
(602) 769-3073

Signed By Date

4/14/2016

340B Drug Pricing Program Database