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CVS PHARMACY, INC.
STD785011 Valley AIDS Council
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Covered Entity Details
Entity Name
Valley AIDS Council
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD785011
Entity Address
300S 2nd Street Suite 101
McAllen, TX 78501
Grant Number
NU62PS924529
Participating Start Date
1/1/2020
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 05641
1500 PADRE BLVD
SOUTH PADRE ISLAND, TX 78597
Pharmacy Comments
Contract Details
Approval Date
1/5/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Wally Cantu, Executive Director
(956) 428-2653
Contract Pharmacy Representative
CVS
Courtney Wilson, Representative
(817) 201-1395
Signed By Date
1/5/2022
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