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AVENUE 360 HEALTH AND WELLNESS
CHC08231-00 HOUSTON COMMUNITY HEALTH CENTERS INC
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Covered Entity Details
Entity Name
HOUSTON COMMUNITY HEALTH CENTERS INC
Subdivision Name
HOUSTON COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CHC08231-00
Entity Address
424 Hahlo St
Houston, TX 77020-3022
Grant Number
H80CS08231
Participating Start Date
9/9/2005
Last Recertification Date
2/10/2025
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
4/8/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/10/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DANIEL MONTEZ, CEO
(713) 343-5450
Contract Pharmacy Representative
Houston Area Community Services dba Avenue 360 Health and Wellness
Joe C. Fuentes, CEO
(713) 426-0027
Signed By Date
4/8/2014
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