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HEB PHARMACY WAREHOUSE 208
STD78759 Texas Health Action
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Covered Entity Details
Entity Name
Texas Health Action
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD78759
Entity Address
8140 N Mopac Expy
Bldg 2
Ste 130
Austin, TX 78759
Grant Number
NH25PS005182
Participating Start Date
10/1/2018
Last Recertification Date
6/1/2023
Entity Termination Date
10/1/2023
Pharmacy Details
Pharmacy Name
HEB PHARMACY WAREHOUSE 208
Pharmacy Address
H-E-B, LP
5311 DIETRICH RD STE 100
SAN ANTONIO, TX 78219
Pharmacy Comments
Contract Details
Approval Date
7/5/2023
Contract Begin Date
7/6/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Chris Adams, CFO
(512) 643-8770
Contract Pharmacy Representative
HEB Pharmacy
Jay Beuche, Manager Contracting
(210) 938-8578
Signed By Date
7/5/2023
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