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MANOR PHARMACY
STD787041 Texas Health Action
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Covered Entity Details
Entity Name
Texas Health Action
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD787041
Entity Address
2800 S. IH-35
103
Austin, TX 78704
Grant Number
NH25PS005182
Participating Start Date
4/1/2020
Last Recertification Date
5/28/2024
Pharmacy Details
Pharmacy Name
MANOR PHARMACY
Pharmacy Address
RSVP HEALTHCARE ALLIANCE, LLC
14008 SHADOW GLEN BLVD STE 102
MANOR, TX 78653
Pharmacy Comments
Contract Details
Approval Date
3/2/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher M Hamilton, CEO
(512) 647-6512
Contract Pharmacy Representative
Manor Pharmacy
Vishal H Patel, Owner
(512) 642-8000
Signed By Date
1/15/2020
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