Contract Pharmacy Details

AZ PHARMACY, LLC
CH015160 EAST BAY COMMUNITY ACTION PROGRAM

Covered Entity Details

Entity Name

EAST BAY COMMUNITY ACTION PROGRAM

Subdivision Name

Newport Health Center

Type

HRSA-Funded Health Center

340B ID

CH015160

Entity Address

6 John H. Chafee Blvd.
Newport, RI 02840-1034

Grant Number

H80CS02329

Participating Start Date

4/1/2005

Last Recertification Date

3/3/2025

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

1/15/2019

Contract Begin Date

4/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Dennis Roy, CEO
(401) 437-1000 Ext: 126

Contract Pharmacy Representative

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

Signed By Date

1/15/2019

340B Drug Pricing Program Database