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PRESCRIPTION SHOP INC
CHC08235-00 Preventative Care Health Services, INC.
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Covered Entity Details
Entity Name
Preventative Care Health Services, INC.
Subdivision Name
Preventative Care Health Services, INC.
Type
HRSA-Funded Health Center
340B ID
CHC08235-00
Entity Address
406 S. SUMMER STREET
MARFA, TX 79843
Grant Number
H80CS08235
Participating Start Date
10/1/2013
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
PRESCRIPTION SHOP INC
Pharmacy Address
909 E. HOLLAND AVE
ALPINE, TX 79830-5023
Pharmacy Comments
Contract Details
Approval Date
4/16/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Coy Boroff, CFO
(432) 729-1812
Contract Pharmacy Representative
Bob Fast, Owner
(432) 837-3498
Signed By Date
4/16/2014
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