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HEB PHARMACY #425
CHC11298-08 TRAVIS COUNTY HEALTHCARE DISTRICT
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Covered Entity Details
Entity Name
TRAVIS COUNTY HEALTHCARE DISTRICT
Subdivision Name
CommUnityCare Rosewood-Zaragosa
Type
HRSA-Funded Health Center
340B ID
CHC11298-08
Entity Address
2802 WEBBERVILLE RD
AUSTIN, TX 78702-2947
Grant Number
H80CS11298
Participating Start Date
12/1/1992
Last Recertification Date
1/25/2017
Entity Termination Date
4/1/2017
Pharmacy Details
Pharmacy Name
HEB PHARMACY #425
Pharmacy Address
1000 E. 41ST STREET
AUSTIN, TX 78751
Pharmacy Comments
Contract Details
Approval Date
7/26/2011
Contract Begin Date
7/26/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2017
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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