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MEDICAL ARTS PHARMACY
CH06657C LA ESPERANZA CLINIC, INC.
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Covered Entity Details
Entity Name
LA ESPERANZA CLINIC, INC.
Subdivision Name
LA ESPERANZA CLINIC, INC. - WEST
Type
HRSA-Funded Health Center
340B ID
CH06657C
Entity Address
34 Buick St
San Angelo, TX 76901-3883
Grant Number
H80CS00203
Participating Start Date
10/1/2009
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
MEDICAL ARTS PHARMACY
Pharmacy Address
2102 PECOS ST
SAN ANGELO, TX 76901-3061
Pharmacy Comments
Contract Details
Approval Date
1/1/2010
Contract Begin Date
1/1/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
DOUG EAKMAN, PRESIDENT
(325) 949-4636
Signed By Date
11/20/2009
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