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RECEPT PHARMACY #1
CHC12863-00 St. Thomas Community Health Center, Inc.
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Covered Entity Details
Entity Name
St. Thomas Community Health Center, Inc.
Subdivision Name
St Thomas CHC at 1936-1938 Magazine Street
Type
HRSA-Funded Health Center
340B ID
CHC12863-00
Entity Address
1936 Magazine St
New Orleans, LA 70130
Grant Number
H80CS12863
Participating Start Date
1/1/2012
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
RECEPT PHARMACY #1
Pharmacy Address
800 8TH AVE STE 130
FORT WORTH, TX 76104
Pharmacy Comments
Contract Details
Approval Date
9/24/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/31/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Donald Erwin, CEO
(504) 529-5558
Contract Pharmacy Representative
Recept Pharmacy
Samantha Burford, Director of 340B Client Services
(817) 602-2332
Signed By Date
9/24/2021
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