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ENCORE PHARMACY #1
CH061335A ST. CHARLES COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
ST. CHARLES COMMUNITY HEALTH CENTER, INC.
Subdivision Name
ST. CHARLES COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH061335A
Entity Address
843 Milling Ave
Luling, LA 70070-4442
Grant Number
H80CS00867
Participating Start Date
10/1/2003
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
ENCORE PHARMACY #1
Pharmacy Address
800 8TH AVE STE 130
FORT WORTH, TX 76104
Pharmacy Comments
Contract Details
Approval Date
5/2/2022
Contract Begin Date
5/4/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARK F. KEISER, CEO
(504) 575-3746
Contract Pharmacy Representative
Encore Pharmacy
SANDRA VALDEZ, 340B Account Manager
(210) 788-9625
Signed By Date
5/2/2022
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