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GERMAN DOBSON CVS, L.L.C.
STD85028 RSG Healthcare
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Covered Entity Details
Entity Name
RSG Healthcare
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD85028
Entity Address
11209 N Tatum BLVD
STE 185
Phoenix, AZ 85028
Grant Number
NU62PS924550
Participating Start Date
7/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
GERMAN DOBSON CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05779
360 N. VAL VISTA DR.
MESA, AZ 85213
Pharmacy Comments
Contract Details
Approval Date
1/8/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Randy S Gelow, Owner/Medical Doctor
(602) 669-2585
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/8/2025
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