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AZ PHARMACY, LLC
CH011430 LYNN COMMUNITY HEALTH, INC.
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Covered Entity Details
Entity Name
LYNN COMMUNITY HEALTH, INC.
Subdivision Name
LYNN COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH011430
Entity Address
269 Union St
Lynn, MA 01901-1314
Grant Number
H80CS00624
Participating Start Date
12/1/1992
Last Recertification Date
2/19/2025
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
1/10/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kiame Mahaniah, Chief Executive Officer
(781) 596-2502 Ext: 2707
Contract Pharmacy Representative
PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725
Signed By Date
1/10/2019
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