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CVS PHARMACY, INC.
CH06084A SU CLINICA FAMILIAR
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Covered Entity Details
Entity Name
SU CLINICA FAMILIAR
Subdivision Name
MULTI-SPECIALTY PRIMARY CARE
Type
HRSA-Funded Health Center
340B ID
CH06084A
Entity Address
1706 TREASURE HILLS BLVD
HARLINGEN, TX 78550
Grant Number
H80CS00348
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 02701
790 ALTON GLOOR BLVD.,
BROWNSVILLE, TX 78526
Pharmacy Comments
Contract Details
Approval Date
7/13/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ELENA MARIN, CEO
(956) 365-6010 Ext: 1330
Contract Pharmacy Representative
CVS Health
Jaclyn Parfitt, 340B Operations Manager
(401) 770-6467
Signed By Date
7/13/2016
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