340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SOUTHSIDE PHARMACY 3
CH062360 BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.
Print
Covered Entity Details
Entity Name
BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.
Subdivision Name
CommuniCare Health Centers - West
Type
HRSA-Funded Health Center
340B ID
CH062360
Entity Address
1102 Barclay St
San Antonio, TX 78207
Grant Number
H80CS00672
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SOUTHSIDE PHARMACY 3
Pharmacy Address
6330 WEST LOOP S STE 700C
BELLAIRE, TX 77401-2928
Pharmacy Comments
Contract Details
Approval Date
4/2/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/11/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Nguyen, President & CEO
(210) 233-7070 Ext: 7886
Contract Pharmacy Representative
Southside Pharmacy
Roshan Koppuzhayil, Director of Pharmacy Operations
(832) 495-5597
Signed By Date
4/2/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session