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GERMAN DOBSON CVS, L.L.C.
CHC28956-00 Valle Del Sol, Inc.
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Covered Entity Details
Entity Name
Valle Del Sol, Inc.
Subdivision Name
Valle del Sol_3807
Type
HRSA-Funded Health Center
340B ID
CHC28956-00
Entity Address
3807 N 7th St
Phoenix, AZ 85014-5005
Grant Number
H80CS28956
Participating Start Date
1/1/2022
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
GERMAN DOBSON CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05029
9230 E. BROADWAY RD.
MESA, AZ 85208
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carmen Heredia, Chief Executive Officer
(602) 258-6797 Ext: 1320
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/13/2023
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