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AHSSHC
CH061260 EAST TEXAS COMMUNITY HEALTH SERVICES, INC
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Covered Entity Details
Entity Name
EAST TEXAS COMMUNITY HEALTH SERVICES, INC
Subdivision Name
Eastside Community Clinic #2
Type
HRSA-Funded Health Center
340B ID
CH061260
Entity Address
1309 S University Dr
Nacogdoches, TX 75961-6486
Grant Number
H80CS00793
Participating Start Date
12/1/1992
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
AHSSHC
Pharmacy Address
EXPEDIEN RX PHARMACY
5050 WESLEY RD STE 120
APOPKA, FL 32712
Pharmacy Comments
Contract Details
Approval Date
10/18/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ROBIN L. MOORE, CEO
(936) 560-5413
Contract Pharmacy Representative
Agape
Trenia Yielding, Executive Director
(407) 357-2601
Signed By Date
10/18/2016
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