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KROGER PHARMACY #607
CHC12885-01 Houston Area Community Services, Inc
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Covered Entity Details
Entity Name
Houston Area Community Services, Inc
Subdivision Name
HACS: Spring-Cypress
Type
HRSA-Funded Health Center
340B ID
CHC12885-01
Entity Address
17010 SUGAR PINE DR
HOUSTON, TX 77090-2213
Grant Number
H80CS12885
Participating Start Date
1/1/2015
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #607
Pharmacy Address
2300 N GESSNER
HOUSTON, TX 77080
Pharmacy Comments
Contract Details
Approval Date
10/25/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mitch Spivey, Executive Vice President, Business Operations
(832) 873-1892
Contract Pharmacy Representative
Houston Area Community Services dba Avenue 360 Health and Wellness
Emmily Simmons, PIC
(713) 426-0027
Signed By Date
10/25/2019
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