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AMAZON PHARMACY #001
CH053200 HealthNet, Inc.
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Covered Entity Details
Entity Name
HealthNet, Inc.
Subdivision Name
HealthNet Administration/HealthNet Specialty Care at Barrington
Type
HRSA-Funded Health Center
340B ID
CH053200
Entity Address
3403 E Raymond St
Indianapolis, IN 46203
Grant Number
H80CS00114
Participating Start Date
12/1/1992
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
AMAZON PHARMACY #001
Pharmacy Address
4500 S PLEASANT VALLEY RD STE 201
AUSTIN, TX 78744-2911
Pharmacy Comments
Contract Details
Approval Date
1/11/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Reifenberg, Chief Medical Officer
(317) 957-2028
Contract Pharmacy Representative
PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725
Signed By Date
1/11/2019
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