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AMAZON PHARMACY #001
CHC24198-00 Marillac Community Health Centers
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Covered Entity Details
Entity Name
Marillac Community Health Centers
Subdivision Name
DCHC-Carrollton
Type
HRSA-Funded Health Center
340B ID
CHC24198-00
Entity Address
3201 S. Carrollton Ave.
New Orleans, LA 70118-4307
Grant Number
H80CS24198
Participating Start Date
10/1/2012
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
AMAZON PHARMACY #001
Pharmacy Address
4500 S PLEASANT VALLEY RD STE 201
AUSTIN, TX 78744-2911
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
Michael Griffin, President and CEO
(504) 212-9502
Contract Pharmacy Representative
PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725
Signed By Date
1/15/2020
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