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LAN RX PHARMACY II
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
LAN RX PHARMACY II
Pharmacy Address
NIGER PHARMACY LLC
1901 FREES STREET
SUITE 2
LAREDO, TX 78046-7129
Pharmacy Comments
Contract Details
Approval Date
4/15/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Elmo S. Lopez Jr., CEO
(956) 625-3001
Contract Pharmacy Representative
Davis Aiyewa, Owner
(956) 568-9230
Signed By Date
4/15/2016
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