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AVELLA OF DEER VALLEY, INC. #38
CH060740 United Medical Centers
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Covered Entity Details
Entity Name
United Medical Centers
Subdivision Name
United Medical Centers Inc.
Type
HRSA-Funded Health Center
340B ID
CH060740
Entity Address
2525 N Veterans Blvd
Eagle Pass, TX 78852-3302
Grant Number
H80CS00643
Participating Start Date
12/1/1992
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
AVELLA OF DEER VALLEY, INC. #38
Pharmacy Address
DBA AVELLA SPECIALTY PHARMACY
24416 N. 19TH AVE
PHOENIX, AZ 85085
Pharmacy Comments
Contract Details
Approval Date
1/15/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/10/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
William Worrell, CEO/Administrator
(830) 773-8917
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Senior Vice President, Strategic Services
(651) 983-0677
Signed By Date
1/15/2018
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