Contract Pharmacy Details

ARIZONA CVS STORES, L.L.C.
CH090080 MARANA HEALTH CENTER, INC.

Covered Entity Details

Entity Name

MARANA HEALTH CENTER, INC.

Subdivision Name

Marana Health Center, Inc.

Type

HRSA-Funded Health Center

340B ID

CH090080

Entity Address

13395 N. Marana Main Street
MARANA, AZ 85653

Grant Number

H80CS00231

Participating Start Date

7/1/1999

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

ARIZONA CVS STORES, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 08828
2090 EAST FRY BLVD.
SIERRA VISTA, AZ 85635

Pharmacy Comments

Contract Details

Approval Date

1/10/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Tamie Olson, Chief Financial Officer
(520) 682-4111 Ext: 6221

Contract Pharmacy Representative

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

Signed By Date

1/10/2022

340B Drug Pricing Program Database