Contract Pharmacy Details

AZ PHARMACY, LLC
CH030700 CENTRAL VIRGINIA HEALTH SERVICES, INC.

Covered Entity Details

Entity Name

CENTRAL VIRGINIA HEALTH SERVICES, INC.

Subdivision Name

CVHS Buckingham

Type

HRSA-Funded Health Center

340B ID

CH030700

Entity Address

25892 N James Madison Hwy
New Canton, VA 23123-2234

Grant Number

H80CS00479

Participating Start Date

7/1/1995

Last Recertification Date

2/28/2025

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

Paula A. Tomko, Chief Executive Officer
(434) 581-3276

Contract Pharmacy Representative

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

Signed By Date

1/15/2019

340B Drug Pricing Program Database