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ST. HOPE PHARMACY
RWI77036 ST. HOPE FOUNDATION, INC.
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Covered Entity Details
Entity Name
ST. HOPE FOUNDATION, INC.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI77036
Entity Address
6200 SAVOY DRIVE
SUITE 540
HOUSTON, TX 77036
Grant Number
H89HA00004
Participating Start Date
12/8/2005
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
ST. HOPE PHARMACY
Pharmacy Address
ST HOPE
6800 WEST LOOP SOUTH
#590
BELLAIRE, TX 77401
Pharmacy Comments
Contract Details
Approval Date
4/16/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/20/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Timika Sam-Cooper, Chief Operations Officer
(713) 778-1300 Ext: 2342
Contract Pharmacy Representative
Patrice Bickley, Pharmacy Manager
(713) 778-1300
Signed By Date
4/16/2014
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