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LAMAR PLAZA DRUG STORE
STD78705 Texas Health Action
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Covered Entity Details
Entity Name
Texas Health Action
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD78705
Entity Address
101 W. Koenig Ln
100
Austin, TX 78751
Grant Number
NH25PS005182
Participating Start Date
1/1/2016
Last Recertification Date
5/28/2024
Pharmacy Details
Pharmacy Name
LAMAR PLAZA DRUG STORE
Pharmacy Address
1509 S LAMAR BLVD STE 550
AUSTIN, TX 78704-2988
Pharmacy Comments
Contract Details
Approval Date
7/13/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joe McAdams, Executive Director
(512) 939-2645
Contract Pharmacy Representative
Martin's Wellness Pharmacy
JIM MARTIN, PHARMACY OWNER
(512) 442-6777
Signed By Date
7/13/2017
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