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HEB PHARMACY #416
CHC24155-01 TEJAS HEALTH CARE
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Covered Entity Details
Entity Name
TEJAS HEALTH CARE
Subdivision Name
Tejas Health Care Giddings: Decker Building
Type
HRSA-Funded Health Center
340B ID
CHC24155-01
Entity Address
185 Decker Drive
GIDDINGS, TX 78942-4252
Grant Number
H80CS24155
Participating Start Date
7/1/2015
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
HEB PHARMACY #416
Pharmacy Address
450 EAST TRAVIS
LA GRANGE, TX 78945
Pharmacy Comments
Contract Details
Approval Date
4/25/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sheri Kehler, CEO
(979) 968-6596 Ext: 120
Contract Pharmacy Representative
HEB
Kimberly Lavrack, Director of Third Party
(210) 938-7344
Signed By Date
4/25/2023
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