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MOHRMANN'S DRUG STORE LLC
CH060810 COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.
Subdivision Name
COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.
Type
HRSA-Funded Health Center
340B ID
CH060810
Entity Address
228 Saint George St
Gonzales, TX 78629-3910
Grant Number
H80CS00125
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
MOHRMANN'S DRUG STORE LLC
Pharmacy Address
2405 WINDING WAY DR
GONZALES, TX 78629
Pharmacy Comments
Contract Details
Approval Date
1/17/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/25/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Henry F. Salas, CEO
(830) 672-6511 Ext: 207
Contract Pharmacy Representative
Mohrmann's Drug Store
Ray Raley, Owner
(830) 857-0881
Signed By Date
1/17/2019
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