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CORRECT RX PHARMACY SERVICES
STD86413 Arizona Department of Corrections, Rehabilitation & Reentry
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Covered Entity Details
Entity Name
Arizona Department of Corrections, Rehabilitation & Reentry
Subdivision Name
ASP - Kingman
Type
Sexually Transmitted Diseases
340B ID
STD86413
Entity Address
4626 W English Dr
Golden Valley, AZ 86413
Grant Number
NH25PS005157-02-02
Participating Start Date
10/1/2023
Last Recertification Date
5/10/2024
Pharmacy Details
Pharmacy Name
CORRECT RX PHARMACY SERVICES
Pharmacy Address
1352 CHARWOOD ROAD
SUITE C
HANOVER, MD 21076
Pharmacy Comments
Contract Details
Approval Date
7/20/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert Lee Ellis, Deputy Assistant Director - CFO
(602) 329-2260
Contract Pharmacy Representative
Correct RX
Hui Seo, Chief Clinical Officer
(443) 557-0100
Signed By Date
7/13/2023
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