340B Drug Pricing Program Database

Pharmacy Name

ESI MAIL PHARMACY SERVICE

Pharmacy Address

DBA EXPRESS SCRIPTS
7909 S HARDY DR STE 106
TEMPE, AZ 85284-1112

Pharmacy Comments

Approval Date

6/5/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Randy S Gelow, Owner/Medical Doctor
(602) 669-2585

Contract Pharmacy Representative

Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044

Signed By Date

4/9/2024