340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2112
HV090750 MARICOPA COUNTY SPECIALTY HEALTH CARE DISTRICT
Print
Covered Entity Details
Entity Name
MARICOPA COUNTY SPECIALTY HEALTH CARE DISTRICT
Subdivision Name
Valleywise Community Health Center - McDowell
Type
Ryan White Part C
340B ID
HV090750
Entity Address
Valleywise Community Health Center - McDowell
1101 N. Central Ave.
Ste. 204
PHOENIX, AZ 85004
Grant Number
H76HA00151
Participating Start Date
7/1/1995
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2112
Pharmacy Address
4915 NORTH PIMA ROAD
SCOTTSDALE, AZ 85251
Pharmacy Comments
Contract Details
Approval Date
4/17/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kris Gaw, Chief Operating Officer
(602) 344-1258
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
4/17/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session