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GERMAN DOBSON CVS, L.L.C.
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
GERMAN DOBSON CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03264
3210 E. UNION HILLS DR.
PHOENIX, AZ 85050
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
Jason Jones, Fiscal Manager
(623) 264-8653
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2024
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