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HEB PHARMACY #425
STD78216 Texas Health Action
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Covered Entity Details
Entity Name
Texas Health Action
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD78216
Entity Address
730 Isom Road
San Antonio, TX 78216
Grant Number
NH25PS005182
Participating Start Date
10/1/2017
Last Recertification Date
5/28/2024
Pharmacy Details
Pharmacy Name
HEB PHARMACY #425
Pharmacy Address
1000 E. 41ST STREET
AUSTIN, TX 78751
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher M Hamilton, CEO
(512) 647-6512
Contract Pharmacy Representative
HEB Pharmacy
Jay Beuche, Manager Contracting
(210) 938-8578
Signed By Date
10/15/2019
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