Contract Pharmacy Details

ARIZONA CVS STORES, L.L.C.
CH090080 MARANA HEALTH CENTER, INC.

Covered Entity Details

Entity Name

MARANA HEALTH CENTER, INC.

Subdivision Name

Marana Health Center, Inc.

Type

HRSA-Funded Health Center

340B ID

CH090080

Entity Address

13395 N. Marana Main Street
MARANA, AZ 85653

Grant Number

H80CS00231

Participating Start Date

7/1/1999

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

ARIZONA CVS STORES, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09302
8920 E TANQUE VERDE
TUCSON, AZ 85749

Pharmacy Comments

Contract Details

Approval Date

10/9/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Tamie Olson, Chief Financial Officer
(520) 682-4111 Ext: 6221

Contract Pharmacy Representative

WellPartner, A CVS Health Company
Derek Sterns, National Sales Representative
(503) 317-9840

Signed By Date

10/9/2019

340B Drug Pricing Program Database