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SIERRA PHAMACY LLC
CH092870 CHIRICAHUA COMMUNITY HEALTH CENTERS INC
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Covered Entity Details
Entity Name
CHIRICAHUA COMMUNITY HEALTH CENTERS INC
Subdivision Name
Chiricahua Community Health Centers, Inc. Cliff Whetten Clinic
Type
HRSA-Funded Health Center
340B ID
CH092870
Entity Address
10566 N Highway 191
Elfrida, AZ 85610-9021
Grant Number
H80CS00696
Participating Start Date
7/1/1998
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
SIERRA PHAMACY LLC
Pharmacy Address
2085 E. FRY BLVD.
SIERRA VISTA, AZ 85635
Pharmacy Comments
Contract Details
Approval Date
1/25/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/26/2020
Ownership change
Contacts
Covered Entity Signing Official
Jonathan Melk, CEO
(520) 227-9167
Contract Pharmacy Representative
Tony Roether, Owner
(520) 459-0705
Signed By Date
1/25/2016
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