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VAUGHANS CITY DRUG CO OF CONC
CH062235A TENSAS COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
TENSAS COMMUNITY HEALTH CENTER
Subdivision Name
TENSAS COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH062235A
Entity Address
402 LEVEE STREET
ST. JOSEPH, LA 71366
Grant Number
H80CS06450
Participating Start Date
10/1/2007
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
VAUGHANS CITY DRUG CO OF CONC
Pharmacy Address
109 EE WALLACE BLVD N
FERRIDAY, LA 71334
Pharmacy Comments
Contract Details
Approval Date
7/16/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JACQUELINE D. SCHAUF, CEO/EXECUTIVE DIRECTOR
(318) 766-1967
Contract Pharmacy Representative
Vaughan's City Drug Company of Concordia, Inc.
Chris Vaughan, POC
(318) 757-4811
Signed By Date
7/16/2018
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