Contract Pharmacy Details

ARIZONA CVS STORES, L.L.C.
CH09008N MARANA HEALTH CENTER, INC.

Covered Entity Details

Entity Name

MARANA HEALTH CENTER, INC.

Subdivision Name

CLINICA DEL ALMA

Type

HRSA-Funded Health Center

340B ID

CH09008N

Entity Address

3690 S Park Ave STE 805
Tucson, AZ 85713-5042

Grant Number

H80CS00231

Participating Start Date

1/1/2008

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

ARIZONA CVS STORES, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09274
615 N. ALVERNON
TUCSON, AZ 85711

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