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PILL BOX INC
CH06796C PROJECT VIDA HEALTH CENTER
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Covered Entity Details
Entity Name
PROJECT VIDA HEALTH CENTER
Subdivision Name
DIANA STREET CLINIC
Type
HRSA-Funded Health Center
340B ID
CH06796C
Entity Address
9565 DIANA DR
EL PASO, TX 79924-6951
Grant Number
H80CS04287
Participating Start Date
10/1/2004
Last Recertification Date
2/6/2017
Entity Termination Date
4/1/2017
Pharmacy Details
Pharmacy Name
PILL BOX INC
Pharmacy Address
DBA BANK PHARMACY #1
4000 MONTANA
EL PASO, TX 79903-4510
Pharmacy Comments
Contract Details
Approval Date
9/21/2010
Contract Begin Date
9/21/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2017
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
9/17/2010
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