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AZ PHARMACY, LLC
CH092240 SHASTA COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
SHASTA COMMUNITY HEALTH CENTER
Subdivision Name
SHASTA COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH092240
Entity Address
1035 Placer St
Redding, CA 96001-1125
Grant Number
H80CS00832
Participating Start Date
4/1/1997
Last Recertification Date
2/12/2025
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
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DEAN C. GERMANO, CEO
(530) 246-5704
Contract Pharmacy Representative
PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725
Signed By Date
10/14/2019
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