Contract Pharmacy Details

RC PHARMACY
RWII78401 Coastal Bend Wellness Foundation

Covered Entity Details

Entity Name

Coastal Bend Wellness Foundation

Subdivision Name

Type

Ryan White Part B

340B ID

RWII78401

Entity Address

5633 S. Staples
Suite 700
Corpus Christi, TX 78414

Grant Number

X07HA00054

Participating Start Date

7/1/2013

Last Recertification Date

2/15/2016

Entity Termination Date

7/1/2016

Pharmacy Details

Pharmacy Name

RC PHARMACY

Pharmacy Address

7515 MAIN STREET
SUITE 780
HOUSTON, TX 77030

Pharmacy Comments

Contract Details

Approval Date

1/15/2015

Contract Begin Date

4/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/11/2016
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Bill Hoelscher, CEO
(361) 814-2001 Ext: 222

Contract Pharmacy Representative

Green Rex, Executive Community Liaison
(713) 660-8888

Signed By Date

1/15/2015

340B Drug Pricing Program Database