Contract Pharmacy Details

SIERRA COMPOUNDING LLC
CH092870 CHIRICAHUA COMMUNITY HEALTH CENTERS INC

Covered Entity Details

Entity Name

CHIRICAHUA COMMUNITY HEALTH CENTERS INC

Subdivision Name

Chiricahua Community Health Centers, Inc. Cliff Whetten Clinic

Type

HRSA-Funded Health Center

340B ID

CH092870

Entity Address

10566 N Highway 191
Elfrida, AZ 85610-9021

Grant Number

H80CS00696

Participating Start Date

7/1/1998

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

SIERRA COMPOUNDING LLC

Pharmacy Address

SIERRA PHARMACY AND COMPOUNDING LAB
2085 E FRY BLVD
SIERRA VISTA, AZ 85635

Pharmacy Comments

Contract Details

Approval Date

4/13/2020

Contract Begin Date

4/13/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jonathan Melk, CEO
(520) 227-9167

Contract Pharmacy Representative

Sierra Pharmacy
Elizabeth Davie, Owner
(520) 459-0705

Signed By Date

4/13/2020

340B Drug Pricing Program Database