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ACCREDO HEALTH GROUP, INC.
STD85392 TL Family Nurse Practice LLC
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Covered Entity Details
Entity Name
TL Family Nurse Practice LLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD85392
Entity Address
13055 West McDowell Road
E-101
Avondale, AZ 85392
Grant Number
NU51PS005142
Participating Start Date
7/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
2 BOULDEN CIR STE 1
NEW CASTLE, DE 19720-3492
Pharmacy Comments
Contract Details
Approval Date
1/10/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tara Begay, FNP/ Co Owner
(602) 918-3225
Contract Pharmacy Representative
Accredo
Diana Florio, 340B Managing Director
(407) 988-7044
Signed By Date
1/10/2025
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