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WAL-MART PHARMACY 10-0473
CHC24155-02 TEJAS HEALTH CARE
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Covered Entity Details
Entity Name
TEJAS HEALTH CARE
Subdivision Name
Tejas Health Care Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC24155-02
Entity Address
890 E Travis St
LA GRANGE, TX 78945
Grant Number
H80CS24155
Participating Start Date
4/1/2017
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0473
Pharmacy Address
US HWY 290/2374 E. AUSTIN
GIDDINGS, TX 78942
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
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
4/25/2023
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