Contract Pharmacy Details

GERMAN DOBSON CVS, L.L.C.
CH093030 ADELANTE HEALTHCARE, INC.

Covered Entity Details

Entity Name

ADELANTE HEALTHCARE, INC.

Subdivision Name

Adelante Healthcare

Type

HRSA-Funded Health Center

340B ID

CH093030

Entity Address

3033 N. Central Ave.
Phoenix, AZ 85012-4403

Grant Number

H80CS00140

Participating Start Date

12/1/1992

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

GERMAN DOBSON CVS, L.L.C.

Pharmacy Address

CVS PHARMACY # 17406
10404 N 43RD AVE
GLENDALE, AZ 85302

Pharmacy Comments

Contract Details

Approval Date

4/13/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Eric Battis, COO
(623) 583-3001 Ext: 1222

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/13/2021

340B Drug Pricing Program Database