340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
COBRE VALLEY COMMUNITY HOSP
CH091300 CANYONLANDS COMMUNITY HEALTH CARE
Print
Covered Entity Details
Entity Name
CANYONLANDS COMMUNITY HEALTH CARE
Subdivision Name
Canyonlands Healthcare - Lake Powell
Type
HRSA-Funded Health Center
340B ID
CH091300
Entity Address
467 VISTA AVENUE
PAGE, AZ 86040
Grant Number
H80CS00448
Participating Start Date
10/1/1998
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
COBRE VALLEY COMMUNITY HOSP
Pharmacy Address
5880 S HOSPITAL DR
OUTPATIENT PHARMACY
GLOBE, AZ 85501-9447
Pharmacy Comments
Contract Details
Approval Date
2/25/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/16/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Christopher Hansen, CEO
(928) 645-6600
Contract Pharmacy Representative
Cobre Valley Regional Medical Center
Jacob D. Albin, Director of Pharmacy Services
(928) 402-1174
Signed By Date
2/25/2016
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