Contract Pharmacy Details

CVS PHARMACY, INC.
RWII78759A Texas Health Action

Covered Entity Details

Entity Name

Texas Health Action

Subdivision Name

Type

Ryan White Part B

340B ID

RWII78759A

Entity Address

2800 S. IH-35
Austin, TX 78704

Grant Number

X07 - HA00054

Participating Start Date

10/1/2019

Last Recertification Date

3/4/2025

Pharmacy Details

Pharmacy Name

CVS PHARMACY, INC.

Pharmacy Address

DBA CVS/PHARMACY #10486
301 CHRIS KELLEY BLVD.
HUTTO, TX 78634

Pharmacy Comments

Contract Details

Approval Date

4/15/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Chris Adams, CFO
(512) 643-8770

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/15/2022

340B Drug Pricing Program Database