Covered Entity Details

CAH451387-00 Uvalde Memorial Hospital (Active) - information as of 5/27/2025 11:40:20 PM

Main Details

Name

Uvalde Memorial Hospital

Subdivision Name

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH451387-00

Medicare Provider Number

451387

Additional Details

Current Program Status

Active

Registration Date

4/19/2017

Participating Start Date

7/1/2017

Participating Approval Date

4/25/2017

Last Recertification Date

9/3/2024

Contacts

Authorizing Official

Uvalde Memorial Hospital
Terri Contreras, Chief Financial Officer
(830) 278-6251 Ext: 1283

Primary Contact

Uvalde Memorial Hospital
ASHISH PUNALEKAR, PHARMACIST
(830) 278-6251 Ext: 1138

Addresses

Street Address

1025 Garner Field Road
Uvalde, TX 78801

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
Participated as DSH450177 from 1/1/2005-7/1/2017. Converted to CAH451387-00 on 7/1/2017.	04/25/2017
Participated as DSH450177 from 1/1/2005-7/1/2017. Converted to CAH 7/1/2017.	04/25/2017

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	H-E-B, LP	H-E-B PHARMACY WAREHOUSE	6520 FRATT RD	SAN ANTONIO	TX	78218	07/17/2017	10/01/2017		10/01/2017
Contract Detail	HEB PHARMACY #441	227 E. MAIN		UVALDE	TX	78801	07/17/2017	10/01/2017		10/01/2017
Contract Detail	HEB PHARMACY WAREHOUSE 208	H-E-B, LP	5311 DIETRICH RD STE 100	SAN ANTONIO	TX	78219	06/30/2023	07/01/2023		07/01/2023
Contract Detail	HEB SPECIALTY PHARMACY #701	3503 FREDERICKSBURG RD	STE 450	SAN ANTONIO	TX	78201	10/16/2023	01/01/2024		01/01/2024
Contract Detail	NOBLE HEALTH SERVICES INC.	6040 TARBELL ROAD		SYRACUSE	NY	13206	07/28/2017	10/01/2017	01/08/2020	01/08/2020
Contract Detail	ONCO360	SINA DRUG, LLC	4700 W SAM HOUSTON PKWY N STE 150	HOUSTON	TX	77041	01/13/2022	04/01/2022		04/01/2022
Contract Detail	PROACT PHARMACY SERVICES, INC.	1226 US HIGHWAY 11		GOUVERNEUR	NY	13642	07/28/2017	10/01/2017	01/08/2020	01/08/2020
Contract Detail	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	01/13/2022	04/01/2022		04/01/2022
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/06/2017	10/01/2017		10/01/2017
Contract Detail	WAL-MART PHARMACY 10-0782	3100 EAST MAIN		UVALDE	TX	78801	07/06/2017	10/01/2017		10/01/2017
Contract Detail	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	07/14/2023	10/01/2023		10/01/2023
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/06/2017	10/01/2017		10/01/2017
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/14/2023	10/01/2023		10/01/2023
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/16/2023	01/01/2024		01/01/2024

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
CAH451387-01	Child	CAH	Uvalde Memorial Hospital	Sabinal Health Clinic	517 North Center Street	Sabinal	TX	Active
CAH451387-02	Child	CAH	Uvalde Memorial Hospital	Primary Care Rural Health Clinic	1025 Garner Field Road	Uvalde	TX	Active
CAH451387-03	Child	CAH	Uvalde Memorial Hospital	UMH HEMATOLOGY AND MEDICAL ONCOLOGY - Hematology and Oncology	1195 GARNER FIELD RD	UVALDE	TX	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	9/8/2023 2:01:25 PM	9/3/2024 8:02:45 AM	9/3/2024 8:02 AM
Details	Last Recertification Date	Update	Recertification	9/12/2022 3:11:48 PM	9/8/2023 2:01:25 PM	9/8/2023 2:01 PM
Details	Last Recertification Date	Update	Recertification	8/17/2021 9:15:19 AM	9/12/2022 3:11:48 PM	9/12/2022 3:11 PM
Contacts	Authorizing Official	Update	Change Request	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	Contreras, Terri Chief Financial Officer Uvalde Memorial Hospital 8302786251-1283	8/18/2022 7:00 AM
Contacts	Authorizing Official	Update	New Registration	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	10/4/2021 1:18 PM
Contacts	Signed By	Update	New Registration	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	10/4/2021 1:18 PM
Details	Last Recertification Date	Update	Recertification	9/3/2020 8:11:33 AM	8/17/2021 9:15:19 AM	8/17/2021 9:15 AM
Details	Last Recertification Date	Update	Recertification	8/21/2019 11:45:12 AM	9/3/2020 8:11:33 AM	9/3/2020 8:11 AM
Details	Last Recertification Date	Update	Recertification	8/21/2018 5:13:36 PM	8/21/2019 11:45:12 AM	8/21/2019 11:45 AM
Details	Last Recertification Date	Update	Recertification	11/20/2017 12:48:35 PM	8/21/2018 5:13:36 PM	8/21/2018 5:13 PM
Contacts	Primary Contact	Insert	Recertification		PUNALEKAR, ASHISH PHARMACIST Uvalde Memorial Hospital 8302786251-1138	11/20/2017 12:48 PM
Details	Last Recertification Date	Update	Recertification		11/20/2017 12:48:35 PM	11/20/2017 12:48 PM
Contacts	Authorizing Official	Update		Lopez, Valerie J. Chief Financial Officer 8302786251-1173	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	11/20/2017 12:23 PM
Contacts	Signed By	Update		Lopez, Valerie J. Chief Financial Officer 8302786251-1173	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	11/20/2017 12:23 PM
Contacts	Authorizing Official	Insert			Lopez, Valerie J. Chief Financial Officer 8302786251-1173	7/28/2017 1:04 PM
Contacts	Signed By	Insert			Lopez, Valerie J. Chief Financial Officer 8302786251-1173	7/28/2017 1:04 PM
Addresses	Main Address	Insert			1025 Garner Field Road Uvalde, TX 78801	4/25/2017 3:47 PM
Dates	Participating Approval Date	Update			4/25/2017 12:00:00 AM	4/25/2017 3:45 PM
Details	State	Update		Pending	Active	4/25/2017 3:45 PM
Dates	Start Date	Update			7/1/2017 12:00:00 AM	4/25/2017 3:45 PM
Details	Comments Public	Insert			Participated as DSH450177 from 1/1/2005-7/1/2017. Converted to CAH451387-00 on 7/1/2017.	4/25/2017 11:22 AM
Details	Comments Public	Insert			Participated as DSH450177 from 1/1/2005-7/1/2017. Converted to CAH 7/1/2017.	4/25/2017 11:21 AM
Details	340B ID	Update		ONLINE_REG_77491	CAH451387-00	4/21/2017 12:45 PM
Details	340B ID	Update			ONLINE_REG_77491	4/19/2017 4:01 PM
Details	Last Recertification Date	Insert				4/19/2017 4:01 PM
Details	Grant Number	Insert				4/19/2017 4:01 PM
Details	340B ID	Insert				4/19/2017 4:01 PM
Details	Is Authorizing Official EHB Data	Insert				4/19/2017 4:01 PM
Dates	Last Date That 340B Drugs Purchased	Insert				4/19/2017 4:01 PM
Details	Medicare Provider Number	Insert			451387	4/19/2017 4:01 PM
Details	Entity Name	Insert			Uvalde Memorial Hospital	4/19/2017 4:01 PM
Details	Program Code	Insert			CAH	4/19/2017 4:01 PM
Details	Entity Subname	Insert				4/19/2017 4:01 PM
Dates	Participating Approval Date	Insert				4/19/2017 4:01 PM
Details	State	Insert			Pending	4/19/2017 4:01 PM
Dates	Registration Date	Insert			4/19/2017 12:00:00 AM	4/19/2017 4:01 PM
Dates	Signed By Date	Insert			4/19/2017 12:00:00 AM	4/19/2017 4:01 PM
Dates	Start Date	Insert				4/19/2017 4:01 PM
Terminations	Termination Comments	Insert				4/19/2017 4:01 PM
Terminations	Termination Date	Insert				4/19/2017 4:01 PM
Terminations	Termination Effective Date	Insert				4/19/2017 4:01 PM
Terminations	Termination Reason	Insert				4/19/2017 4:01 PM