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ARIZONA CVS STORES, L.L.C.
STD85224 Institute for Liver Health
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Covered Entity Details
Entity Name
Institute for Liver Health
Subdivision Name
Chandler
Type
Sexually Transmitted Diseases
340B ID
STD85224
Entity Address
2201 West Fairview St
Ste. 9
Chandler, AZ 85224
Grant Number
NU51PS005142
Participating Start Date
1/1/2022
Last Recertification Date
5/22/2024
Pharmacy Details
Pharmacy Name
ARIZONA CVS STORES, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08977
3501 STOCKTON HILL RD.
KINGMAN, AZ 86409
Pharmacy Comments
Contract Details
Approval Date
7/14/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anita Kohli, CEO
(434) 825-0921
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2023
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