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GERMAN DOBSON CVS, L.L.C.
STD85282 Be Well Family Care
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Covered Entity Details
Entity Name
Be Well Family Care
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD85282
Entity Address
1492 S. MILL AVE.
SUITE 212
Tempe, AZ 85281
Grant Number
NU51PS005142
Participating Start Date
4/1/2022
Last Recertification Date
5/8/2024
Pharmacy Details
Pharmacy Name
GERMAN DOBSON CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 17256
1800 E RIO SALADO PKWY STE 120
TEMPE, AZ 85281
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
5/16/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Micaela Aida Simon, Owner/Provider
(480) 410-4128
Contract Pharmacy Representative
WellPartner
Anthony McEeachern, Anthony McEachern
(315) 314-1802
Signed By Date
4/15/2022
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