Contract Pharmacy Details

GERMAN DOBSON CVS, L.L.C.
CH09008J MARANA HEALTH CENTER, INC.

Covered Entity Details

Entity Name

MARANA HEALTH CENTER, INC.

Subdivision Name

MARANA HEALTH CENTER OBSTETRICS AND GYNECOLOGY

Type

HRSA-Funded Health Center

340B ID

CH09008J

Entity Address

2055 W Hospital Dr STE 115
Tucson, AZ 85704-7823

Grant Number

H80CS00231

Participating Start Date

10/1/2004

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

GERMAN DOBSON CVS, L.L.C.

Pharmacy Address

CVS PHARMACY # 17223
4040 N ORACLE RD
TUCSON, AZ 85705

Pharmacy Comments

Contract Details

Approval Date

10/13/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

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