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CVS PHARMACY, INC.
CH06325AJ EL CENTRO DEL BARRIO
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Covered Entity Details
Entity Name
EL CENTRO DEL BARRIO
Subdivision Name
CentroMed SA Pediatrics
Type
HRSA-Funded Health Center
340B ID
CH06325AJ
Entity Address
3327 Research Plaza
STE 307
San Antonio, TX 78235-5158
Grant Number
H80CS00758
Participating Start Date
10/1/2022
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 05512
7208 FM 78
SAN ANTONIO, TX 78244
Pharmacy Comments
Contract Details
Approval Date
7/8/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ernesto Gomez, President / CEO
(210) 334-3703
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/8/2024
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