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GERMAN DOBSON CVS, L.L.C.
STD85224 Institute for Liver Health
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Covered Entity Details
Entity Name
Institute for Liver Health
Subdivision Name
Chandler
Type
Sexually Transmitted Diseases
340B ID
STD85224
Entity Address
2201 West Fairview St
Ste. 9
Chandler, AZ 85224
Grant Number
NU51PS005142
Participating Start Date
1/1/2022
Last Recertification Date
5/22/2024
Pharmacy Details
Pharmacy Name
GERMAN DOBSON CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03965
5975 W. CHANDLER BLVD.
CHANDLER, AZ 85226
Pharmacy Comments
Contract Details
Approval Date
11/3/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anita Kohli, CEO
(434) 825-0921
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/13/2021
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