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ARIZONA CVS STORES, L.L.C.
CHC26604-05 NEIGHBORHOOD OUTREACH ACCESS TO HEALTH
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Covered Entity Details
Entity Name
NEIGHBORHOOD OUTREACH ACCESS TO HEALTH
Subdivision Name
Desert Mission Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26604-05
Entity Address
9015 N 3rd St
PHOENIX, AZ 85020
Grant Number
H80CS26604
Participating Start Date
1/1/2016
Last Recertification Date
2/12/2025
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
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Julia Karl, CFO
(480) 688-0970
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/12/2023
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