340B Drug Pricing Program Database
AMAZON PHARMACY #001
CH042430 THE COASTAL FAMILY HEALTH CENTER INC - information as of 5/3/2025 11:34:36 PM
Covered Entity Details
Entity Name
THE COASTAL FAMILY HEALTH CENTER INC
Subdivision Name
COASTAL FAMILY HEALTH CENTER CORPORATE OFFICE
Type
HRSA-Funded Health Center
340B ID
CH042430
Entity Address
10467 Corporate Drive
Gulfport, MS 39503
Grant Number
H80CS00188
Participating Start Date
7/1/1999
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
AMAZON PHARMACY #001
Pharmacy Address
4500 S PLEASANT VALLEY RD STE 201
AUSTIN, TX 78744-2911
Pharmacy Comments
Contract Details
Approval Date
4/7/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ANGEL GREER, CEO
(228) 374-2494 Ext: 1133
Contract Pharmacy Representative
PillPack by Amazon Pharmacy
John Lavin, Vice President
(714) 380-0579
Signed By Date
4/7/2025
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