Contract Pharmacy Details

ASPCARES
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

ASPCARES

Pharmacy Address

1300 3RD ST
CORPUS CHRISTI, TX 78404-2208

Pharmacy Comments

Contract Details

Approval Date

4/15/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2016

Contacts

Covered Entity Signing Official

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

Contract Pharmacy Representative

ASP
Victoria Fernandez, National Director of Sales and Marketing
(214) 519-2090 Ext: 308

Signed By Date

4/15/2016

340B Drug Pricing Program Database