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FAMILY PHARMACY CARE - WEST
CHC24153-01 ASIAN AMERICAN HEALTH COALITION OF THE GREATER HOUSTON AREA, INC.
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Covered Entity Details
Entity Name
ASIAN AMERICAN HEALTH COALITION OF THE GREATER HOUSTON AREA, INC.
Subdivision Name
HOPE Clinic WEST
Type
HRSA-Funded Health Center
340B ID
CHC24153-01
Entity Address
12121 Westheimer Road Suite 205
Houston, TX 77077-6682
Grant Number
H80CS24153
Participating Start Date
10/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
FAMILY PHARMACY CARE - WEST
Pharmacy Address
12121 RICHMOND AVE
SUITE 126
HOUSTON, TX 77082
Pharmacy Comments
Contract Details
Approval Date
1/5/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/14/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Andrea Caracostis, Chief Executive Officer
(713) 337-3640
Contract Pharmacy Representative
Pham Nguyen, Owner
(281) 315-3990
Signed By Date
1/5/2015
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