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CVS PHARMACY, INC.
CH06084A SU CLINICA FAMILIAR
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Covered Entity Details
Entity Name
SU CLINICA FAMILIAR
Subdivision Name
MULTI-SPECIALTY PRIMARY CARE
Type
HRSA-Funded Health Center
340B ID
CH06084A
Entity Address
1706 TREASURE HILLS BLVD
HARLINGEN, TX 78550
Grant Number
H80CS00348
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY #02182
4531 PADRE ISLAND HIGHWAY
BROWNSVILLE, TX 78521
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
7/15/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
ELENA MARIN, CEO
(956) 365-6010 Ext: 1330
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2021
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