Contract Pharmacy Details

GERMAN DOBSON CVS, L.L.C.
CH09008C MARANA HEALTH CENTER, INC.

Covered Entity Details

Entity Name

MARANA HEALTH CENTER, INC.

Subdivision Name

Keeling Health Center

Type

HRSA-Funded Health Center

340B ID

CH09008C

Entity Address

435 EAST GLENN STREET
TUCSON, AZ 85705

Grant Number

H80CS00231

Participating Start Date

7/1/2003

Last Recertification Date

1/31/2024

Entity Termination Date

10/1/2024

Pharmacy Details

Pharmacy Name

GERMAN DOBSON CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 07867
5100 E. GRANT RD.
TUCSON, AZ 85712

Pharmacy Comments

Contract Details

Approval Date

10/13/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Tamie Olson, Chief Financial Officer
(520) 682-4111 Ext: 6221

Contract Pharmacy Representative

WellPartner, A CVS Health Company
Derek Sterns, National Sales Representative
(503) 317-9840

Signed By Date

10/13/2023

340B Drug Pricing Program Database