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GADDIS PHARMACY
CH062120 SOUTH TEXAS RURAL HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
SOUTH TEXAS RURAL HEALTH SERVICES, INC.
Subdivision Name
SOUTH TEXAS RURAL HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH062120
Entity Address
105 SOUTH STEWART STREET
COTULLA, TX 78014-2237
Grant Number
H80CS00361
Participating Start Date
12/1/1992
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
GADDIS PHARMACY
Pharmacy Address
302 NORTH MAIN ST
COTULLA, TX 78014
Pharmacy Comments
Contract Details
Approval Date
7/1/2002
Contract Begin Date
7/1/2002
Carve-In Effective Date
Contract Comments
4/25/06 - ADMIN CORRECTION - ORIGINALLY LINKED TO CH06212A
Contract Termination Date
Termination Reason
3/1/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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