340B Drug Pricing Program Database
LIFECARE GARZA PHARMACY
CH063250 El Centro Del Barrio - information as of 6/2/2025 8:50:32 AM
Covered Entity Details
Entity Name
El Centro Del Barrio
Subdivision Name
CentroMed Southside Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CH063250
Entity Address
3750 Commercial Ave
San Antonio, TX 78221-3117
Grant Number
H80CS00758
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
LIFECARE GARZA PHARMACY
Pharmacy Address
4500 S PLEASANT VALLEY RD STE 100
AUSTIN, TX 78744
Pharmacy Comments
Contract Details
Approval Date
10/11/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ernesto Gomez, President / CEO
(210) 334-3703
Contract Pharmacy Representative
Lifecare Pavilion, LLC
Sunil Arvishetty, Pharmacist in Charge
(210) 212-7455
Signed By Date
10/11/2019
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