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HEB PHARMACY #168
CH061510 Brownsville Community Health Clinic Corporation
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Covered Entity Details
Entity Name
Brownsville Community Health Clinic Corporation
Subdivision Name
New Horizon Medical Center
Type
HRSA-Funded Health Center
340B ID
CH061510
Entity Address
191 E. Price Rd.
Brownsville, TX 78521-3527
Grant Number
H80CS00717
Participating Start Date
12/1/1992
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
HEB PHARMACY #168
Pharmacy Address
1103 MORGAN BLVD
HARLINGEN, TX 78550
Pharmacy Comments
Contract Details
Approval Date
7/14/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jason K Wallace, CEO
(956) 548-7473
Contract Pharmacy Representative
HEB
Kimberly Lavrack, Director of Third Party
(210) 938-7344
Signed By Date
7/14/2024
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