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TOWN CENTER PHARMACY
CH062120 SOUTH TEXAS RURAL HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
SOUTH TEXAS RURAL HEALTH SERVICES, INC.
Subdivision Name
SOUTH TEXAS RURAL HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH062120
Entity Address
105 SOUTH STEWART STREET
COTULLA, TX 78014-2237
Grant Number
H80CS00361
Participating Start Date
12/1/1992
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
TOWN CENTER PHARMACY
Pharmacy Address
PHARM HOUSE CARRIZO SPRINGS, LLC
3531 TOWN CENTER BLVD S STE 103
SUGAR LAND, TX 77479
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/3/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
ALFREDO ZAMORA Jr., CEO
(830) 879-3047 Ext: 206
Contract Pharmacy Representative
Black Bear Pharmacy, Inc.
Loren Pierce, Main POC
(404) 807-6205
Signed By Date
4/15/2020
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