Covered Entity Details

STD77469 Fort Bend County Health and Human Services (Active) - information as of 4/29/2025 11:58:22 PM

Main Details

Name

Fort Bend County Health and Human Services

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD77469

Grant Number

NH25PS005182

Nature of Support
Please Describe the “in-kind” Support
Time period section 318 funding or in-kind support was received

Direct Funding (dollars received from CDC or an intermediate organization)
Note: In-kind contributions may be in the form of real property, equipment, supplies and other expendable property, and goods and services directly benefiting and specifically identifiable to the project or program.

1/1/2019 - 8/31/2025

Additional Details

Current Program Status

Active

Registration Date

6/4/2020

Participating Start Date

6/26/2020

Participating Approval Date

6/26/2020

Last Recertification Date

5/17/2024

Notice of Funding Opportunity (NOFO) Number

PS19-1901

Contacts

Authorizing Official

Fort Bend County Health and Human Services
Letosha Gale-Lowe, HHS Director and LHA
(281) 238-3500

Primary Contact

Fort Bend County Health and Human Service
Nichole R Brathwaite-Dingle, Deputy Medical Director
(832) 535-6684

Addresses

Street Address

4520 Reading Road
Rosenberg, TX 77471

Billing Address

Fort Bend County Health and Human Services
301 Jackson Street
Richmond, TX 77469

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

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

Shipping Addresses

Shipping Address 1

Fort Bend County Health and Human Services
4520 Reading Road
A-200
Rosenberg, TX 77471

Shipping Address 2

Fort Bend County Health and Human Services
307 Texas Parkway
148
Missouri City, TX 77489

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15320	4101 GREENBRIAR DR STE 235	HOUSTON	TX	77098	10/13/2022	01/01/2023			01/01/2023
Contract Detail	Walgreens MFC #21373	4100 Dale Earnhardt Way	200	Northlake	TX	76262	04/15/2025	07/01/2025			04/15/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Nature of Support: Support Received From Date	Update	Change Request	7/1/2020 12:00:00 AM	1/1/2019 12:00:00 AM	3/25/2025 6:19 AM
Contacts	Primary Contact	Update	Change Request	Inamdar, Ketan Deputy Director - Operations \|Finance \|Social Services Fort Bend County Health and Human Services 2812383233	Brathwaite-Dingle, Nichole R Deputy Medical Director Fort Bend County Health and Human Service 8325356684	3/25/2025 6:19 AM
Details	Nature of Support: Support Received To Date	Update	Change Request	1/31/2025 12:00:00 AM	8/31/2025 12:00:00 AM	3/18/2025 3:29 PM
Details	Last Recertification Date	Update	Recertification	5/11/2023 5:05:27 PM	5/17/2024 10:29:34 AM	5/17/2024 10:29 AM
Contacts	Authorizing Official	Update	AO Change Request	Minter, Jacquelyn Director of Health and Human Services Fort Bend County 2812383512	Gale-Lowe, Letosha HHS Director and LHA Fort Bend County Health and Human Services 2812383500	5/15/2024 2:53 PM
Details	Nature of Support: Support Received To Date	Update	Change Request		1/31/2025 12:00:00 AM	1/11/2024 12:52 AM
Contacts	Primary Contact	Update	Change Request	Mbise, Lilian RN - Clinic Supervisor Fort Bend County Health and Human Services 2814038095	Inamdar, Ketan Deputy Director - Operations \|Finance \|Social Services Fort Bend County Health and Human Services 2812383233	6/2/2023 9:42 AM
Details	Last Recertification Date	Update	Recertification	5/11/2022 1:02:47 AM	5/11/2023 5:05:27 PM	5/11/2023 5:05 PM
Addresses	Main Address	Update	Change Request	301 Jackson Street Richmond, TX 77469	4520 Reading Road Rosenberg, TX 77471	1/23/2023 6:31 AM
Addresses	Shipping Address	Delete	Change Request	Fort Bend County Health and Human Services 4520 Reading Road Rosenberg, TX 77471		1/23/2023 6:31 AM
Addresses	Shipping Address	Delete	Change Request	Fort Bend County Health and Human Services 307 Texas Parkway (FM 2234) Suite 148 Missouri City, TX 77489		1/23/2023 6:31 AM
Addresses	Billing Address	Insert	Change Request		Fort Bend County Health and Human Services 301 Jackson Street Richmond, TX 77469	1/23/2023 6:31 AM
Addresses	Shipping Address	Insert	Change Request		Fort Bend County Health and Human Services 4520 Reading Road A-200 Rosenberg, TX 77471	1/23/2023 6:31 AM
Addresses	Shipping Address	Insert	Change Request		Fort Bend County Health and Human Services 307 Texas Parkway 148 Missouri City, TX 77489	1/23/2023 6:31 AM
Details	Last Recertification Date	Update	Recertification	6/3/2021 12:35:40 PM	5/11/2022 1:02:47 AM	5/11/2022 1:02 AM
Contacts	Primary Contact	Update	Change Request	Adesope, Ben Deputy Chief - Health and Human Services Fort Bend County Health and Human Services 8328416089	Mbise, Lilian RN - Clinic Supervisor Fort Bend County Health and Human Services 2814038095	2/9/2022 2:01 PM
Addresses	Shipping Address	Insert	Change Request		Fort Bend County Health and Human Services 307 Texas Parkway (FM 2234) Suite 148 Missouri City, TX 77489	10/18/2021 6:55 AM
Details	Nature of Support: Support Received From Date	Update	Recertification		7/1/2020 12:00:00 AM	6/3/2021 12:35 PM
Details	Last Recertification Date	Update	Recertification		6/3/2021 12:35:40 PM	6/3/2021 12:35 PM
Details	NOFO Number	Update	Recertification		PS19-1901	6/3/2021 12:35 PM
Details	State	Update	OPA Edit	Approved	Active	6/26/2020 9:03 AM
Dates	Start Date	Update	OPA Edit	7/1/2020 12:00:00 AM	6/26/2020 12:00:00 AM	6/26/2020 9:03 AM
Contacts	Signed By	Insert	New Registration		Minter, Jacquelyn Director of Health and Human Services Fort Bend County 2812383512	6/26/2020 9:02 AM
Details	340B ID	Update	New Registration		STD77469	6/26/2020 9:02 AM
Dates	Participating Approval Date	Update	New Registration		6/26/2020 9:02:06 AM	6/26/2020 9:02 AM
Details	State	Update	New Registration	Pending	Approved	6/26/2020 9:02 AM
Dates	Signed By Date	Update	New Registration		6/4/2020 8:08:07 PM	6/26/2020 9:02 AM
Dates	Start Date	Update	New Registration		7/1/2020 12:00:00 AM	6/26/2020 9:02 AM
Addresses	Main Address	Insert	New Registration		301 Jackson Street Richmond, TX 77469	6/4/2020 4:28 PM
Addresses	Shipping Address	Insert	New Registration		Fort Bend County Health and Human Services 4520 Reading Road Rosenberg, TX 77471	6/4/2020 4:28 PM
Details	Nature Of Support	Insert	New Registration		Direct Funding (dollars received from CDC or an intermediate organization)	6/4/2020 4:28 PM
Contacts	Primary Contact	Insert	New Registration		Adesope, Ben Deputy Chief - Health and Human Services Fort Bend County Health and Human Services 8328416089	6/4/2020 4:28 PM
Contacts	Authorizing Official	Insert	New Registration		Minter, Jacquelyn Director of Health and Human Services Fort Bend County 2812383512	6/4/2020 4:28 PM
Details	Last Recertification Date	Insert	New Registration			6/4/2020 4:28 PM
Details	Grant Number	Insert	New Registration		NH25PS005182	6/4/2020 4:28 PM
Details	340B ID	Insert	New Registration			6/4/2020 4:28 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			6/4/2020 4:28 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			6/4/2020 4:28 PM
Details	Medicare Provider Number	Insert	New Registration			6/4/2020 4:28 PM
Details	Entity Name	Insert	New Registration		Fort Bend County Health and Human Services	6/4/2020 4:28 PM
Details	Program Code	Insert	New Registration		STD	6/4/2020 4:28 PM
Details	Entity Subname	Insert	New Registration			6/4/2020 4:28 PM
Dates	Participating Approval Date	Insert	New Registration			6/4/2020 4:28 PM
Details	State	Insert	New Registration		Pending	6/4/2020 4:28 PM
Dates	Registration Date	Insert	New Registration		6/4/2020 4:28:08 PM	6/4/2020 4:28 PM
Dates	Signed By Date	Insert	New Registration			6/4/2020 4:28 PM
Dates	Start Date	Insert	New Registration			6/4/2020 4:28 PM
Terminations	Termination Comments	Insert	New Registration			6/4/2020 4:28 PM
Terminations	Termination Date	Insert	New Registration			6/4/2020 4:28 PM
Terminations	Termination Effective Date	Insert	New Registration			6/4/2020 4:28 PM
Terminations	Termination Reason	Insert	New Registration			6/4/2020 4:28 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History