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HEB PHARMACY WAREHOUSE 208
CHC11255-02 STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC
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Covered Entity Details
Entity Name
STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC
Subdivision Name
Women and Children's Health Center
Type
HRSA-Funded Health Center
340B ID
CHC11255-02
Entity Address
218 E HOUSE ST
ALVIN, TX 77511-3544
Grant Number
H80CS11255
Participating Start Date
4/1/2016
Last Recertification Date
2/11/2025
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
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mark Young, CEO
(281) 824-1480
Contract Pharmacy Representative
HEB
Kimberly Lavrack, Director of Third Party
(210) 938-7344
Signed By Date
10/12/2023
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