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CLINIC PHARMACY
CH06074J United Medical Centers
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Covered Entity Details
Entity Name
United Medical Centers
Subdivision Name
UNITED MEDICAL CENTERS # 2
Type
HRSA-Funded Health Center
340B ID
CH06074J
Entity Address
202 JAMES STREET
BRACKETTVILLE, TX 78832
Grant Number
H80CS00643
Participating Start Date
7/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CLINIC PHARMACY
Pharmacy Address
BRACKETTVILLE PHARMACY, LLC
201 JAMES ST, U 1378
BRACKETTVILLE, TX 78832-5117
Pharmacy Comments
Contract Details
Approval Date
1/14/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
William Worrell, CEO/Administrator
(830) 773-8917
Contract Pharmacy Representative
united medical centers
Michael Luna, Pharmacist
(830) 773-5358 Ext: 239
Signed By Date
1/14/2020
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