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AMAZON PHARMACY #010
CH046150 AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.
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Covered Entity Details
Entity Name
AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.
Subdivision Name
AARON E. HENRY - CLARKSDALE CLINIC
Type
HRSA-Funded Health Center
340B ID
CH046150
Entity Address
800 Ohio Ave
Clarksdale, MS 38614-7200
Grant Number
H80CS00480
Participating Start Date
7/1/1998
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
AMAZON PHARMACY #010
Pharmacy Address
1331 E 6TH ST
CORONA, CA 92879
Pharmacy Comments
Contract Details
Approval Date
7/17/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
AURELIA JONES-TAYLOR, CEO
(662) 624-4292 Ext: 1119
Contract Pharmacy Representative
AMAZON PHARMACY
JOHN M LAVIN, MANAGING OFFICER
(602) 793-8552
Signed By Date
7/17/2024
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