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CHALLENGE CARE PHARMACY
STD78208 San Antonio AIDS Foundation
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Covered Entity Details
Entity Name
San Antonio AIDS Foundation
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD78208
Entity Address
818 E. Grayson St
San Antonio, TX 78208
Grant Number
NU62PS924529
Participating Start Date
4/1/2017
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
CHALLENGE CARE PHARMACY
Pharmacy Address
CHALLENGE CARE PHARMACY LLC
6105 BEVERLYHILL ST STE 200
HOUSTON, TX 77057
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/15/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Cynthia Nelson, Chief Executive Officer
(210) 225-4715 Ext: 122
Contract Pharmacy Representative
Elite Analytics Group, Inc
Rex Green, CEO
(469) 899-2293
Signed By Date
10/15/2019
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