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AVENUE 360 HEALTH AND WELLNESS
CH0622420 SPRING BRANCH COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
SPRING BRANCH COMMUNITY HEALTH CENTER
Subdivision Name
SBCHC - Hillendahl Clinic
Type
HRSA-Funded Health Center
340B ID
CH0622420
Entity Address
1615 Hillendahl Blvd.
Suite 100
Houston, TX 77055
Grant Number
H80CS06447
Participating Start Date
4/1/2008
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
AVENUE 360 HEALTH AND WELLNESS
Pharmacy Address
2150 W 18TH ST STE 300
SERVICE JOBS FOR PROGRESS
HOUSTON, TX 77008
Pharmacy Comments
Contract Details
Approval Date
7/3/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Marlen Trujillo, Chief Executive Officer
(713) 462-6565 Ext: 118
Contract Pharmacy Representative
Houston Area Community Services dba Avenue 360 Health and Wellness
Joe C. Fuentes, CEO
(713) 426-0027
Signed By Date
7/3/2014
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