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AZ PHARMACY, LLC
CHC11332-00 COMMUNITY HEALTH CENTERS OF GREATER DAYTON
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF GREATER DAYTON
Subdivision Name
Community Health Centers of Greater Dayton - Charles Drew Health Center
Type
HRSA-Funded Health Center
340B ID
CHC11332-00
Entity Address
1323 W. 3rd St.
Dayton, OH 45402-6714
Grant Number
H80CS12882
Participating Start Date
10/1/2009
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
AZ PHARMACY, LLC
Pharmacy Address
DBA AMAZON PHARMACY #002
3809 E WATKINS ST
PHOENIX, AZ 85034
Pharmacy Comments
Contract Details
Approval Date
1/4/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GREGORY HOPKINS, EXECUTIVE DIRECTOR
(937) 586-9733 Ext: 1023
Contract Pharmacy Representative
PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725
Signed By Date
1/4/2019
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