340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0413
CH06084A SU CLINICA FAMILIAR
Print
Covered Entity Details
Entity Name
SU CLINICA FAMILIAR
Subdivision Name
MULTI-SPECIALTY PRIMARY CARE
Type
HRSA-Funded Health Center
340B ID
CH06084A
Entity Address
1706 TREASURE HILLS BLVD
HARLINGEN, TX 78550
Grant Number
H80CS00348
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0413
Pharmacy Address
1401 WEST HWY 100
PORT ISABEL, TX 78578
Pharmacy Comments
Contract Details
Approval Date
1/16/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ELENA MARIN, CEO
(956) 365-6010 Ext: 1330
Contract Pharmacy Representative
Walmart
Tisha Campbell, Director of Contracting
(949) 872-4138
Signed By Date
1/16/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session