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AVELLA OF DEER VALLEY
CH090160 EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
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Covered Entity Details
Entity Name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Subdivision Name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH090160
Entity Address
839 WEST CONGRESS ST
TUCSON, AZ 85745
Grant Number
H80CS00230
Participating Start Date
12/1/1992
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
AVELLA OF DEER VALLEY
Pharmacy Address
23620 N 20TH DR #12
PHOENIX, AZ 85085-0621
Pharmacy Comments
Contract Details
Approval Date
9/15/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/1/2021
Ownership change
Contacts
Covered Entity Signing Official
Nancy Johnson, CEO
(520) 309-2011
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Senior Vice President, Strategic Services
(651) 983-0677
Signed By Date
9/15/2015
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