Contract Pharmacy Details

AZ PHARMACY, LLC
CH024490 NORTH HUDSON COMMUNITY ACTION CORPORATION

Covered Entity Details

Entity Name

NORTH HUDSON COMMUNITY ACTION CORPORATION

Subdivision Name

North Hudson Community Action Corporation @ West New York

Type

HRSA-Funded Health Center

340B ID

CH024490

Entity Address

5301 BROADWAY
WEST NEW YORK, NJ 07093-2622

Grant Number

H80CS00521

Participating Start Date

1/1/2004

Last Recertification Date

2/10/2025

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

1/8/2019

Contract Begin Date

4/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/15/2019
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Joan Quigley, President/CEO
(201) 210-0100 Ext: 10100

Contract Pharmacy Representative

PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725

Signed By Date

1/8/2019

340B Drug Pricing Program Database