Contract Pharmacy Details

WAL-MART PHARMACY 10-0772
CHC24153-00 ASIAN AMERICAN HEALTH COALITION OF THE GREATER HOUSTON AREA, INC.

Covered Entity Details

Entity Name

ASIAN AMERICAN HEALTH COALITION OF THE GREATER HOUSTON AREA, INC.

Subdivision Name

Asian American Health Coalition of the Greater Houston Area

Type

HRSA-Funded Health Center

340B ID

CHC24153-00

Entity Address

7001 Corporate Dr STE 120
Houston, TX 77036-5139

Grant Number

H80CS24153

Participating Start Date

1/1/2013

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-0772

Pharmacy Address

3506 S HWY 6 SOUTH
HOUSTON, TX 77082

Pharmacy Comments

Contract Details

Approval Date

7/14/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/13/2021
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Andrea Caracostis, Chief Executive Officer
(713) 337-3640

Contract Pharmacy Representative

Walmart
Julie Howard, 340B Program Manager
(479) 277-1498

Signed By Date

7/14/2021

340B Drug Pricing Program Database