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RAY'S CITY DRUG
CAH451392-00 Hamilton General Hospital
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Covered Entity Details
Entity Name
Hamilton General Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH451392-00
Entity Address
400 North Brown
Hamilton, TX 76531
Medicare Provider Number
451392
Participating Start Date
4/1/2019
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
RAY'S CITY DRUG
Pharmacy Address
RAY'S CITY DRUG, INC.
105 E HENRY ST
HAMILTON, TX 76531
Pharmacy Comments
Contract Details
Approval Date
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tammy Schreiber, CFO
(254) 386-1528
Contract Pharmacy Representative
Rays Town North Pharmacy
Jeff Alsabrook, Owner
(817) 832-2626
Signed By Date
1/17/2023
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