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DENVER HEALTH CENTRAL FILL PHARMACY
RWIID802221 COLORADO DEPT OF PUBLIC HEALTH & ENVIRONMENT
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Covered Entity Details
Entity Name
COLORADO DEPT OF PUBLIC HEALTH & ENVIRONMENT
Subdivision Name
RYAN WHITE CARE PROGRAM
Type
Ryan White Part B ADAP Direct Purchase
340B ID
RWIID802221
Entity Address
4300 CHERRY CREEK DRIVE SOUTH
DENVER, CO 80246-1530
Grant Number
X07HA00056
Participating Start Date
4/1/1997
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
DENVER HEALTH CENTRAL FILL PHARMACY
Pharmacy Address
DENVER HEALTH AND HOSPITAL AUTHORITY
500 QUIVAS ST
STE A
DENVER, CO 80204
Pharmacy Comments
Contract Details
Approval Date
4/12/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tanya Gray, Deputy Branch Chief
(303) 692-2703
Contract Pharmacy Representative
Jason Atlas, Pharmacy Director
(303) 602-8535
Signed By Date
4/12/2013
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