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NPS PHARMACY DIRECT
RWI85007 RipplePHX
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Covered Entity Details
Entity Name
RipplePHX
Subdivision Name
Type
Ryan White Part A
340B ID
RWI85007
Entity Address
1423 W Indian School Rd
Phoenix, AZ 85013
Grant Number
H89HA11478
Participating Start Date
1/1/2024
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
NPS PHARMACY DIRECT
Pharmacy Address
442 METROPLEX DR
STE 401
NASHVILLE, TN 37211
Pharmacy Comments
Contract Details
Approval Date
11/3/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jason Jones, Fiscal Manager
(623) 264-8653
Contract Pharmacy Representative
NPS
Ashley Williams, Pharmacist
(615) 831-2291 Ext: 227
Signed By Date
10/16/2023
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