340B Drug Pricing Program Database
HEB PHARMACY #385
DSH450388 METHODIST HOSPITAL - information as of 4/29/2025 5:22:52 AM
Covered Entity Details
Entity Name
METHODIST HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450388
Entity Address
7700 FLOYD CURL DRIVE
SAN ANTONIO, TX 78229-3902
Medicare Provider Number
450388
Participating Start Date
1/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
HEB PHARMACY #385
Pharmacy Address
300 W. OLMOS DR
SAN ANTONIO, TX 78212
Pharmacy Comments
Contract Details
Approval Date
4/11/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Enrique Bernal, DCFO
(210) 575-0235
Contract Pharmacy Representative
HEB
Kimberly Lavrack, Director of Third Party
(210) 938-7344
Signed By Date
4/11/2025
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