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ARIZONA CVS STORES, L.L.C.
CH090160 EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
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Covered Entity Details
Entity Name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Subdivision Name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH090160
Entity Address
839 WEST CONGRESS ST
TUCSON, AZ 85745
Grant Number
H80CS00230
Participating Start Date
12/1/1992
Last Recertification Date
2/11/2025
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
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nancy Johnson, CEO
(520) 309-2011
Contract Pharmacy Representative
WellPartner, A CVS Health Company
Derek Sterns, National Sales Representative
(503) 317-9840
Signed By Date
1/15/2020
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