340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
EPIC PHARMACY
RW431241 San Antonio AIDS Foundation
Print
Covered Entity Details
Entity Name
San Antonio AIDS Foundation
Subdivision Name
Type
Ryan White Part D
340B ID
RW431241
Entity Address
818 E. Grayson St.
San Antonio, TX 78208
Grant Number
H12HA31241
Participating Start Date
4/1/2019
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
EPIC PHARMACY
Pharmacy Address
EPIC PHARMACY LLC
2249 NW 39TH ST
OKLAHOMA CITY, OK 73112
Pharmacy Comments
Contract Details
Approval Date
6/29/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/15/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Cherise Rohr-Allegrini, Chief Executive Officer
(210) 225-4715 Ext: 122
Contract Pharmacy Representative
Elite Analytics Group, Inc
Rex Green, CEO
(469) 899-2293
Signed By Date
6/29/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session