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CVS PHARMACY, INC.
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
CVS PHARMACY, INC.
Pharmacy Address
DBA CVS/PHARMACY # 10221
2502 TRIMMIER RD.
KILLEEN, TX 76542
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
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
10/15/2020
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