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SUPER MERCADO PHARMACY
CH062248C MIDLAND COMMUNITY HEALTHCARE SERVICES
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Covered Entity Details
Entity Name
MIDLAND COMMUNITY HEALTHCARE SERVICES
Subdivision Name
MIDLAND CHC WOMEN'S SERVICES
Type
HRSA-Funded Health Center
340B ID
CH062248C
Entity Address
400 ROSALIND REDFERN GROVER PKWY
Midland, TX 79701-5846
Grant Number
H80CS06455
Participating Start Date
1/1/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SUPER MERCADO PHARMACY
Pharmacy Address
2208 N BIG SPRING ST
MIDLAND, TX 79705-8823
Pharmacy Comments
Contract Details
Approval Date
3/8/2006
Contract Begin Date
3/8/2006
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
3/7/2006
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