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FRY'S PRESCRIPTION PHARMACY
RWII70 VALLEY AIDS COUNCIL
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Covered Entity Details
Entity Name
VALLEY AIDS COUNCIL
Subdivision Name
Type
Ryan White Part B
340B ID
RWII70
Entity Address
2306 CAMELOT PLAZA CIRCLE
HARLINGEN, TX 78550
Grant Number
X07HA00054
Participating Start Date
12/1/1992
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
FRY'S PRESCRIPTION PHARMACY
Pharmacy Address
311 N. SAM HOUSTON
SAN BENITO, TX 78586-4656
Pharmacy Comments
Contract Details
Approval Date
3/22/2019
Contract Begin Date
3/25/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Wally Cantu, Executive Director
(956) 428-2653
Contract Pharmacy Representative
Fry's Pharmacy
Abigial Vasquez, Owner
(956) 399-2453
Signed By Date
3/22/2019
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