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MXP PHARMACY
CHC28976-00 COASTAL BEND WELLNESS FOUNDATION, INC.
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Covered Entity Details
Entity Name
COASTAL BEND WELLNESS FOUNDATION, INC.
Subdivision Name
Coastal Bend Wellness Foundation
Type
HRSA-Funded Health Center
340B ID
CHC28976-00
Entity Address
2882 Holly Road
Corpus Christi, TX 78415-4106
Grant Number
H80CS28976
Participating Start Date
4/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MXP PHARMACY
Pharmacy Address
416 S TYLER ST
AMARILLO, TX 79101
Pharmacy Comments
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bill Hoelscher, CEO
(361) 814-2001 Ext: 222
Contract Pharmacy Representative
Maxor National Pharmacy Services, LLC
Ross Halsne, VP, Market Strategy
(612) 210-8655
Signed By Date
4/15/2019
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