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WAL-MART CENTRAL FILL 10-2670
CH061730 GULF COAST HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
GULF COAST HEALTH CENTER, INC.
Subdivision Name
GULF COAST HEALTH CENTER, INC. - PORT ARTHUR
Type
HRSA-Funded Health Center
340B ID
CH061730
Entity Address
2548 Memorial Blvd
Port Arthur, TX 77640-2825
Grant Number
H80CS00408
Participating Start Date
7/1/1997
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART CENTRAL FILL 10-2670
Pharmacy Address
608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386
Pharmacy Comments
Contract Details
Approval Date
7/13/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marsha E. Thigpen, Executive Director
(409) 983-1161 Ext: 880
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/13/2018
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