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RED RIVER PHARMACY OF ATLANTA
CH0627930 EAST TEXAS BORDER HEALTH CLINIC
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Covered Entity Details
Entity Name
EAST TEXAS BORDER HEALTH CLINIC
Subdivision Name
East Texas Border Health Clinic DBA Genesis Primecare Marshall 2
Type
HRSA-Funded Health Center
340B ID
CH0627930
Entity Address
400 S Alamo Blvd
Marshall, TX 75670-4260
Grant Number
H80CS08781
Participating Start Date
10/1/2007
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RED RIVER PHARMACY OF ATLANTA
Pharmacy Address
PHARM HOLDINGS LLC
102 E ALLDAY ST
ATLANTA, TX 75551-2305
Pharmacy Comments
Contract Details
Approval Date
7/15/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/6/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Carla Roadcap, CEO
(903) 927-3782
Contract Pharmacy Representative
Coy Williamson, President
(903) 799-7737
Signed By Date
7/15/2015
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