340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PRIME THERAPEUTICS SPECIALTY PHARMACY LL
CH08126G MOUNTAIN FAMILY HEALTH CENTERS
Print
Covered Entity Details
Entity Name
MOUNTAIN FAMILY HEALTH CENTERS
Subdivision Name
MOUNTAIN FAMILY HEALTH CENTERS AVON SCHOOL-BASED HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH08126G
Entity Address
0850 West Beaver Creek Blvd
Avon, CO 81620
Grant Number
H80CS00830
Participating Start Date
1/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
PRIME THERAPEUTICS SPECIALTY PHARMACY LL
Pharmacy Address
ALLIANCERX WALGREENS PRIME #16568
2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDO, FL 32819-9992
Pharmacy Comments
Contract Details
Approval Date
3/2/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/5/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Art M Fernandez, Chief Operating Officer
(970) 945-2840 Ext: 7205
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
3/2/2018
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