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EL RIO PHARMACY
CH061750 GATEWAY COMMUNITY HEALTH CENTER INC
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Covered Entity Details
Entity Name
GATEWAY COMMUNITY HEALTH CENTER INC
Subdivision Name
GATEWAY COMMUNITY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH061750
Entity Address
1515 Pappas St
Laredo, TX 78041-1705
Grant Number
H80CS00779
Participating Start Date
12/1/1992
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
EL RIO PHARMACY
Pharmacy Address
6801 MCPHERSON RD STE102
LAREDO, TX 78041
Pharmacy Comments
Contract Details
Approval Date
1/19/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2016
Ownership change
Contacts
Covered Entity Signing Official
Miguel Trevino Jr., CEO
(956) 523-3645
Contract Pharmacy Representative
Polo Ruiz, Owner
(956) 723-2001
Signed By Date
1/19/2016
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