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NEIGHBORHOOD PHARMACY
SCH450144-00 Andrews Co Hospital District dba Permian Regional Medical Center
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Covered Entity Details
Entity Name
Andrews Co Hospital District dba Permian Regional Medical Center
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH450144-00
Entity Address
720 Hospital Drive
Andrews, TX 79714
Medicare Provider Number
450144
Participating Start Date
7/1/2013
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
NEIGHBORHOOD PHARMACY
Pharmacy Address
801 N MAIN ST, STE-F
ANDREWS, TX 79714-4026
Pharmacy Comments
Contract Details
Approval Date
7/8/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sandra K. Cox, CFO
(432) 266-8190
Contract Pharmacy Representative
Hiren Darji, Pharmacist in Charge
(432) 523-7000
Signed By Date
7/8/2013
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