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DEWEY PHARMACY
CH09942B Yavapai County Community Health Services
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Covered Entity Details
Entity Name
Yavapai County Community Health Services
Subdivision Name
COTTONWOOD
Type
HRSA-Funded Health Center
340B ID
CH09942B
Entity Address
51 Brian Mickelsen Parkway
Cottonwood, AZ 86326-4236
Grant Number
H80CS00842
Participating Start Date
4/1/2020
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
DEWEY PHARMACY
Pharmacy Address
NORTHERN ARIZONA PHARMACY, LLC
12075 E STATE ROUTE 69 STE E
DEWEY, AZ 86327-4517
Pharmacy Comments
Contract Details
Approval Date
6/25/2021
Contract Begin Date
6/29/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sharon Rickman, Director
(928) 442-5285
Contract Pharmacy Representative
Chino Valley Pharmacy
Jason Dykstra, Manager
(928) 515-0046
Signed By Date
6/25/2021
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