Contract Pharmacy Details

AMAZON PHARMACY #006
CH092870 CHIRICAHUA COMMUNITY HEALTH CENTERS INC

Covered Entity Details

Entity Name

CHIRICAHUA COMMUNITY HEALTH CENTERS INC

Subdivision Name

Chiricahua Community Health Centers, Inc. Cliff Whetten Clinic

Type

HRSA-Funded Health Center

340B ID

CH092870

Entity Address

10566 N Highway 191
Elfrida, AZ 85610-9021

Grant Number

H80CS00696

Participating Start Date

7/1/1998

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

AMAZON PHARMACY #006

Pharmacy Address

3620 PLAINFIELD RD
INDIANAPOLIS, IN 46231-7003

Pharmacy Comments

Contract Details

Approval Date

10/15/2024

Contract Begin Date

1/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jonathan Melk, CEO
(520) 227-9167

Contract Pharmacy Representative

PillPack by Amazon Pharmacy
John Lavin, Vice President
(714) 380-0579

Signed By Date

10/15/2024

340B Drug Pricing Program Database