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PRIMESOURCE RX, LLC
CHC24153-00 ASIAN AMERICAN HEALTH COALITION OF THE GREATER HOUSTON AREA, INC.
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Covered Entity Details
Entity Name
ASIAN AMERICAN HEALTH COALITION OF THE GREATER HOUSTON AREA, INC.
Subdivision Name
Asian American Health Coalition of the Greater Houston Area
Type
HRSA-Funded Health Center
340B ID
CHC24153-00
Entity Address
7001 Corporate Dr STE 120
Houston, TX 77036-5139
Grant Number
H80CS24153
Participating Start Date
1/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
PRIMESOURCE RX, LLC
Pharmacy Address
2656 S LOOP W STE 574
HOUSTON, TX 77054
Pharmacy Comments
Contract Details
Approval Date
7/4/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/28/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Andrea Caracostis, Chief Executive Officer
(713) 337-3640
Contract Pharmacy Representative
PrimsourceRx
Quan Tran, CFO
(832) 464-7616
Signed By Date
7/4/2019
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