Contract Pharmacy Details

EXPRESS SCRIPTS PHARMACY, INC.
CH093030 ADELANTE HEALTHCARE, INC.

Covered Entity Details

Entity Name

ADELANTE HEALTHCARE, INC.

Subdivision Name

Adelante Healthcare

Type

HRSA-Funded Health Center

340B ID

CH093030

Entity Address

3033 N. Central Ave.
Phoenix, AZ 85012-4403

Grant Number

H80CS00140

Participating Start Date

12/1/1992

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

EXPRESS SCRIPTS PHARMACY, INC.

Pharmacy Address

DBA EXPRESS SCRIPTS
2040 ROUTE 130 NORTH
BURLINGTON, NJ 08016

Pharmacy Comments

Contract Details

Approval Date

4/16/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Pedro Cons, CEO
(623) 583-3001 Ext: 011105

Contract Pharmacy Representative

Express Scripts
Gene McCabe, 340B Lead Director
(615) 943-7500

Signed By Date

4/16/2025

340B Drug Pricing Program Database