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CVS PHARMACY, INC.
CH061223R Brazos Valley Community Action Agency, Inc.
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Covered Entity Details
Entity Name
Brazos Valley Community Action Agency, Inc.
Subdivision Name
BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.
Type
HRSA-Funded Health Center
340B ID
CH061223R
Entity Address
1500 University Dr E
College Station, TX 77840-2600
Grant Number
H80CS00299
Participating Start Date
4/1/2020
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
CVS PHARMACY # 16251
2100 TEXAS AVE S
COLLEGE STATION, TX 77840
Pharmacy Comments
Contract Details
Approval Date
10/2/2024
Contract Begin Date
10/2/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Theresa Sabella, Dr.
(979) 383-2348
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/2/2024
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