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AZ PHARMACY, LLC
CH041110 FETTER HEALTHCARE NETWORK INC.
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Covered Entity Details
Entity Name
FETTER HEALTHCARE NETWORK INC.
Subdivision Name
FRANKLIN C FETTER FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH041110
Entity Address
51 Nassau St
Charleston, SC 29403-5513
Grant Number
H80CS09088
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
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
1/14/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Aretha Jones, CEO
(843) 722-4112 Ext: 3004
Contract Pharmacy Representative
AZ Pharmacy LLC
Geoff Swindle, Chief Business Officer
(801) 809-2584
Signed By Date
1/14/2019
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