Contract Pharmacy Details

AMAZON PHARMACY #001
CH090780 Community Medical Centers, Inc.

Covered Entity Details

Entity Name

Community Medical Centers, Inc.

Subdivision Name

Community Medical Centers, Channel

Type

HRSA-Funded Health Center

340B ID

CH090780

Entity Address

701 E Channel St.
Stockton, CA 95202-2628

Grant Number

H80CS00138

Participating Start Date

12/1/1992

Last Recertification Date

2/21/2025

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

4/15/2020

Contract Begin Date

5/11/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Christine Noguera, CEO
(209) 373-2826

Contract Pharmacy Representative

PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725

Signed By Date

4/15/2020

340B Drug Pricing Program Database