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BRICK STREET PHARMACY
CHC08217-00 LONGVIEW WELLNESS CENTER, INC.
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Covered Entity Details
Entity Name
LONGVIEW WELLNESS CENTER, INC.
Subdivision Name
Wellness Pointe - Longview Buliding 3
Type
HRSA-Funded Health Center
340B ID
CHC08217-00
Entity Address
1107 E. Marshall Avenue
Building 3
Longview, TX 75601
Grant Number
H80CS08217
Participating Start Date
10/1/2009
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
BRICK STREET PHARMACY
Pharmacy Address
314 W RUSK ST
TYLER, TX 75701-1513
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Chad Jones, Chief Executive Officer
(903) 212-4777
Contract Pharmacy Representative
Brick Street Pharmacy
Jeffrey Abeldt, Pharmacist in Charge
(903) 533-8155
Signed By Date
4/15/2021
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