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UNITED PHARMACY #634
CH06374H NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER
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Covered Entity Details
Entity Name
NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER
Subdivision Name
Community Healthcare Center at Zundy
Type
HRSA-Funded Health Center
340B ID
CH06374H
Entity Address
2412 Avenue H
Wichita Falls, TX 76309-3233
Grant Number
H80CS00553
Participating Start Date
10/1/2020
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
UNITED PHARMACY #634
Pharmacy Address
2720 SOUTHWEST PKWY
WICHITA FALLS, TX 76308
Pharmacy Comments
Contract Details
Approval Date
4/10/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allen Patterson, CEO
(940) 397-2602
Contract Pharmacy Representative
Albertsons
Chuch Hansen, 340B Manager
(208) 395-6304
Signed By Date
4/10/2024
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