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HEB PHARMACY #294
CH06325C 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
CH06325C
Entity Address
1034 W County Line Rd
New Braunfels, TX 78130-8338
Grant Number
H80CS00758
Participating Start Date
4/1/1995
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
HEB PHARMACY #294
Pharmacy Address
6580 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
HEB Pharmacy
Jay Beuche, Manager Contracting
(210) 938-8578
Signed By Date
7/8/2024
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