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SMITH'S FOOD AND DRUG
SCH030007-00 VERDE VALLEY MEDICAL CENTER
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Covered Entity Details
Entity Name
VERDE VALLEY MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH030007-00
Entity Address
269 SOUTH CANDY LANE
COTTONWOOD, AZ 86326
Medicare Provider Number
030007
Participating Start Date
9/30/2010
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
SMITH'S FOOD AND DRUG
Pharmacy Address
DBA FRY'S FOOD AND DRUG #103
1100-A HIGHWAY 260
COTTONWOOD, AZ 86326
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/30/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Clifford F Loader, Chief Financial Officer
(928) 773-2282
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
7/15/2020
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