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ESI MAIL PHARMACY SERVICE
FQHCLA431 VALLEY HEALTH PARTNERS COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
VALLEY HEALTH PARTNERS COMMUNITY HEALTH CENTER
Subdivision Name
Family Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA431
Entity Address
400 N 17th St
STE 300
Allentown, PA 18104
Grant Number
LALCS45056
Participating Start Date
1/1/2022
Last Recertification Date
2/24/2025
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
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/14/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Veronica Gonzalez, Chief Executive Officer
(610) 969-2728
Contract Pharmacy Representative
Express Scripts
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/15/2022
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