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HEB PHARMACY #382
FQHCLA307A Ector County Hospital District
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Covered Entity Details
Entity Name
Ector County Hospital District
Subdivision Name
Ector County Hospital District
Type
Health Center Program Look-Alike
340B ID
FQHCLA307A
Entity Address
6030 W UNIVERSITY BLVD
ODESSA, TX 79764-8530
Grant Number
LALCS00007
Participating Start Date
10/1/2015
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HEB PHARMACY #382
Pharmacy Address
3325 WEST WADLEY
MIDLAND, TX 79707
Pharmacy Comments
Contract Details
Approval Date
1/10/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/16/2018
Agreement registered in error
Contacts
Covered Entity Signing Official
David M Garcia, Executive Director
(432) 640-4868
Contract Pharmacy Representative
HEB Pharmacy
Jay Beuche, Manager Contracting
(210) 938-8578
Signed By Date
1/10/2017
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