340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CVS PHARMACY, INC.
SCH450210-00 East Texas Medical Center Carthage
Print
Covered Entity Details
Entity Name
East Texas Medical Center Carthage
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH450210-00
Entity Address
409 West Cottage Road
Carthage, TX 75633
Medicare Provider Number
450210
Participating Start Date
7/1/2013
Last Recertification Date
11/8/2017
Entity Termination Date
4/1/2018
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 07480
640 HURST STREET
CENTER, TX 75935
Pharmacy Comments
Contract Details
Approval Date
10/14/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Gary Hudson, Administrator
(903) 694-4652
Contract Pharmacy Representative
CVS Rx Services, Inc
Jordan Birnbaum, 340B Vendor Manager
(401) 770-2241
Signed By Date
10/14/2014
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session