Contract Pharmacy Details

ARIZONA CVS STORES, L.L.C.
CHC12845-00 NATIVE HEALTH

Covered Entity Details

Entity Name

NATIVE HEALTH

Subdivision Name

NATIVE HEALTH West 8800

Type

HRSA-Funded Health Center

340B ID

CHC12845-00

Entity Address

8800 N 22nd Ave
Phoenix, AZ 85021

Grant Number

H80CS12845

Participating Start Date

4/1/2012

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

ARIZONA CVS STORES, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09297
6002 NORTH 7TH STREET
PHOENIX, AZ 85014

Pharmacy Comments

Contract Details

Approval Date

10/9/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Walter Murillo, Chief Executive Officer
(602) 279-5262

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/9/2023

340B Drug Pricing Program Database