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AZ PHARMACY, LLC
CH092176B WESTERN SIERRA MEDICAL CLINIC INC
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Covered Entity Details
Entity Name
WESTERN SIERRA MEDICAL CLINIC INC
Subdivision Name
Western Sierra Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CH092176B
Entity Address
844 Old Tunnel Rd
Grass Valley, CA 95945-5952
Grant Number
H80CS08234
Participating Start Date
4/1/2010
Last Recertification Date
2/13/2025
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
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott McFarland, Chief Executive Officer
(530) 273-4984 Ext: 115
Contract Pharmacy Representative
PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725
Signed By Date
10/15/2019
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