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WAL-MART PHARMACY 10-4538
CH062242B SPRING BRANCH COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
SPRING BRANCH COMMUNITY HEALTH CENTER
Subdivision Name
Spring Branch Community Health Center West Houston Clinc
Type
HRSA-Funded Health Center
340B ID
CH062242B
Entity Address
19333 Clay Rd
Katy, TX 77449-4001
Grant Number
H80CS06447
Participating Start Date
7/1/2014
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4538
Pharmacy Address
6060 NORTH FRY ROAD
KATY, TX 77449
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
Marlen Trujillo, Chief Executive Officer
(713) 462-6565 Ext: 118
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/17/2023
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