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CVS PHARMACY, INC.
CHC11298-62 TRAVIS COUNTY HEALTHCARE DISTRICT
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Covered Entity Details
Entity Name
TRAVIS COUNTY HEALTHCARE DISTRICT
Subdivision Name
CommUnityCare Pflugerville
Type
HRSA-Funded Health Center
340B ID
CHC11298-62
Entity Address
2700 W Pecan St Ste 450
Pflugerville, TX 78660-3154
Grant Number
H80CS11298
Participating Start Date
7/1/2023
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 00357
1701 E. PARMER LN.
AUSTIN, TX 78754
Pharmacy Comments
Contract Details
Approval Date
7/22/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jaeson Fournier, CEO
(512) 978-9050 Ext: 5125954337
Contract Pharmacy Representative
Montana CVS Pharmacy, LLC
Christian Reid, Senior Director
(401) 770-2118
Signed By Date
7/22/2024
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