Contract Pharmacy Details

AZ PHARMACY, LLC
CH047000 HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.

Covered Entity Details

Entity Name

HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.

Subdivision Name

Health Care Partners of South Carolina, Inc. - Conway Administrative Office

Type

HRSA-Funded Health Center

340B ID

CH047000

Entity Address

1708 Oak Street
Conway, SC 29526-3086

Grant Number

H80CS00411

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

Jim Eubanks, Chief Executive Officer
(843) 488-6363

Contract Pharmacy Representative

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

Signed By Date

1/14/2019

340B Drug Pricing Program Database