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CVS PHARMACY, INC.
CH061730 GULF COAST HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
GULF COAST HEALTH CENTER, INC.
Subdivision Name
GULF COAST HEALTH CENTER, INC. - PORT ARTHUR
Type
HRSA-Funded Health Center
340B ID
CH061730
Entity Address
2548 Memorial Blvd
Port Arthur, TX 77640-2825
Grant Number
H80CS00408
Participating Start Date
7/1/1997
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 00851
485 TEXAS AVE
BRIDGE CITY, TX 77611
Pharmacy Comments
Contract Details
Approval Date
1/9/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marsha E. Thigpen, Executive Director
(409) 983-1161 Ext: 880
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/9/2024
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