Contract Pharmacy Details

AVELLA OF ORLANDO
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 ORLANDO

Pharmacy Address

100 TECHNOLOGY PARK STE 155
LAKE MARY, FL 32746-6205

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

10/1/2017
Business decision by covered entity and/or pharmacy

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