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ARIZONA CVS STORES, L.L.C.
CH090560 UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
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Covered Entity Details
Entity Name
UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Subdivision Name
UNITED HEALTH CENTERS PARLIER
Type
HRSA-Funded Health Center
340B ID
CH090560
Entity Address
650 S Zediker Ave
Parlier, CA 93648-2639
Grant Number
H80CS00137
Participating Start Date
12/1/1992
Last Recertification Date
2/24/2021
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
ARIZONA CVS STORES, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09327
6021 S CENTRAL AVE
PHOENIX, AZ 85042
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/15/2020
Agreement registered in error
Contacts
Covered Entity Signing Official
COLLEEN CURTIS, CEO
(559) 646-6618 Ext: 0007
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2020
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