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WESTERN PHARMACY GROUP LLC
CH090080 MARANA HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
MARANA HEALTH CENTER, INC.
Subdivision Name
Marana Health Center, Inc.
Type
HRSA-Funded Health Center
340B ID
CH090080
Entity Address
13395 N. Marana Main Street
MARANA, AZ 85653
Grant Number
H80CS00231
Participating Start Date
7/1/1999
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WESTERN PHARMACY GROUP LLC
Pharmacy Address
DBA COMMUNITY MEDICAL CENTER PHARMACY
610 GATEWAY CENTER WAY
SUITES A--E
SAN DIEGO, CA 92102
Pharmacy Comments
Contract Details
Approval Date
4/20/2018
Contract Begin Date
4/20/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/8/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tamie Olson, Chief Financial Officer
(520) 682-4111 Ext: 6221
Contract Pharmacy Representative
Western Pharmacy Group LLC
KEVIN FARIS, CEO
(360) 685-4263
Signed By Date
4/20/2018
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