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DIAGNOSTIC CLINIC OF LONGVIEW PHARMACY
CHC08217-00 LONGVIEW WELLNESS CENTER, INC.
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Covered Entity Details
Entity Name
LONGVIEW WELLNESS CENTER, INC.
Subdivision Name
Wellness Pointe - Longview Buliding 3
Type
HRSA-Funded Health Center
340B ID
CHC08217-00
Entity Address
1107 E. Marshall Avenue
Building 3
Longview, TX 75601
Grant Number
H80CS08217
Participating Start Date
10/1/2009
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
DIAGNOSTIC CLINIC OF LONGVIEW PHARMACY
Pharmacy Address
ASSOCIATED CLINICIANS OF EAST TX PLLC
709 HOLLYBROOK DR, STE 4500
LONGVIEW, TX 75605
Pharmacy Comments
Contract Details
Approval Date
10/5/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Chad Jones, Chief Executive Officer
(903) 212-4777
Contract Pharmacy Representative
Diagnostic Clinic of Longview
Sau-Chi Goretti Lau, Pharmacist in Charge
(903) 291-6216
Signed By Date
10/5/2022
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