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ESI MAIL PHARMACY SERVICE
CH036640 CHASE BREXTON HEALTH SERVICES, INC
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Covered Entity Details
Entity Name
CHASE BREXTON HEALTH SERVICES, INC
Subdivision Name
Chase Brexton Health Services, Inc.
Type
HRSA-Funded Health Center
340B ID
CH036640
Entity Address
1111 North Charles Street
Baltimore, MD 21201-5505
Grant Number
H80CS00734
Participating Start Date
4/1/1997
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
ESI MAIL PHARMACY SERVICE
Pharmacy Address
DBA EXPRESS SCRIPTS
7909 S HARDY DR STE 106
TEMPE, AZ 85284-1112
Pharmacy Comments
Contract Details
Approval Date
1/4/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eric Turnbaugh, CFO
(410) 837-2050 Ext: 1148
Contract Pharmacy Representative
Express Scripts
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/4/2022
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