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WAL-MART PHARMACY 10-0413
CH061510 Brownsville Community Health Clinic Corporation
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Covered Entity Details
Entity Name
Brownsville Community Health Clinic Corporation
Subdivision Name
New Horizon Medical Center
Type
HRSA-Funded Health Center
340B ID
CH061510
Entity Address
191 E. Price Rd.
Brownsville, TX 78521-3527
Grant Number
H80CS00717
Participating Start Date
12/1/1992
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0413
Pharmacy Address
1401 WEST HWY 100
PORT ISABEL, TX 78578
Pharmacy Comments
Contract Details
Approval Date
1/13/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
PAULA S. GOMEZ, CEO
(956) 548-7473
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/13/2022
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