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CVS PHARMACY, INC.
STD78216 Texas Health Action
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Covered Entity Details
Entity Name
Texas Health Action
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD78216
Entity Address
730 Isom Road
San Antonio, TX 78216
Grant Number
NH25PS005182
Participating Start Date
10/1/2017
Last Recertification Date
5/19/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
CVS PHARMACY # 16853
4522 FREDERICKSBURG RD
BALCONES HEIGHTS, TX 78201
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher M Hamilton, CEO
(512) 647-6512
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2020
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