340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ARIZONA CVS STORES, L.L.C.
DSH030022 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Print
Covered Entity Details
Entity Name
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH030022
Entity Address
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT DBA VALLEYWISE HEALTH
2601 EAST ROOSEVELT STREET
PHOENIX, AZ 85008
Medicare Provider Number
030022
Participating Start Date
10/4/2018
Last Recertification Date
8/24/2024
Pharmacy Details
Pharmacy Name
ARIZONA CVS STORES, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 8983
5125 W. OLIVE AVE
GLENDALE, AZ 85302
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kris Gaw, Chief Operating Officer
(602) 344-1258
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session