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HEALTHY CITY PHARMACY
CH06658E Centro San Vicente at Pebble Hills
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Covered Entity Details
Entity Name
Centro San Vicente at Pebble Hills
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH06658E
Entity Address
PEBBLE VILLAGE SHOPPING CENTER 10780 PEBBLE HILLS BLVD STE G1
EL PASO, TX 79935-2039
Grant Number
H80CS00637
Participating Start Date
4/1/2017
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
HEALTHY CITY PHARMACY
Pharmacy Address
EZ SCRIPTS LLC
3028 TRAWOOD DR STE D
EL PASO, TX 79936
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/13/2023
Agreement registered in error
Contacts
Covered Entity Signing Official
Christina Ilene Paz, CEO
(915) 859-7545 Ext: 1232
Contract Pharmacy Representative
HEALTHY CITY PHARMACY
AMRISH PATEL, MANAGER
(972) 207-0045
Signed By Date
1/15/2020
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