Contract Pharmacy Details

SALINAS PHARMACY
CH06084C SU CLINICA FAMILIAR

Covered Entity Details

Entity Name

SU CLINICA FAMILIAR

Subdivision Name

Southern Cameron County Clinic

Type

HRSA-Funded Health Center

340B ID

CH06084C

Entity Address

105 E. Alton Gloor Blvd.
BROWNSVILLE, TX 78526

Grant Number

H80CS00348

Participating Start Date

7/1/1993

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

SALINAS PHARMACY

Pharmacy Address

500 N SAM HOUSTON STE 1
SAN BENITO, TX 78586

Pharmacy Comments

Contract Details

Approval Date

4/15/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2016
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

ELENA MARIN, CEO
(956) 365-6010 Ext: 1330

Contract Pharmacy Representative

Gil Salina, Pharmacy manager
(956) 963-6333

Signed By Date

4/15/2016