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LARSON'S PHARMACY
CH062237A SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
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Covered Entity Details
Entity Name
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Subdivision Name
ResourceCare Cross Plains
Type
HRSA-Funded Health Center
340B ID
CH062237A
Entity Address
301 S Main St
Cross Plains, TX 76443-2581
Grant Number
H80CS06460
Participating Start Date
7/1/2011
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
LARSON'S PHARMACY
Pharmacy Address
BIG COUNTRY ENTERPRISES, INC.
109 NE 2ND ST
CROSS PLAINS, TX 76443-2401
Pharmacy Comments
Contract Details
Approval Date
9/14/2012
Contract Begin Date
9/14/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Dustin Hawk, CEO
(325) 893-4010 Ext: 111
Contract Pharmacy Representative
Larson's
Rene Ramirez, Pharmacy Director
(432) 661-5285
Signed By Date
8/23/2012
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