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CVS PHARMACY, INC.
CH063010 LA CLINICA DE FAMILIA, INC.
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Covered Entity Details
Entity Name
LA CLINICA DE FAMILIA, INC.
Subdivision Name
LCDF Administration Office
Type
HRSA-Funded Health Center
340B ID
CH063010
Entity Address
385 Calle de Alegra BLDG A
Las Cruces, NM 88005
Grant Number
H80CS00316
Participating Start Date
12/1/1992
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA CVS/PHARMACY #11020
680 E. REDD RD.
EL PASO, TX 79912
Pharmacy Comments
Contract Details
Approval Date
4/14/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Virgil Medina, CEO
(575) 526-1105
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2022
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