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HEPCARE PHARMACY
CHC28976-00 COASTAL BEND WELLNESS FOUNDATION, INC.
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Covered Entity Details
Entity Name
COASTAL BEND WELLNESS FOUNDATION, INC.
Subdivision Name
Coastal Bend Wellness Foundation
Type
HRSA-Funded Health Center
340B ID
CHC28976-00
Entity Address
2882 Holly Road
Corpus Christi, TX 78415-4106
Grant Number
H80CS28976
Participating Start Date
4/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
HEPCARE PHARMACY
Pharmacy Address
2200 PARK BEND DR.
BLDG.1, SUITE 300
AUSTIN, TX 78758-4182
Pharmacy Comments
Contract Details
Approval Date
10/26/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/23/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Bill Hoelscher, CEO
(361) 814-2001 Ext: 222
Contract Pharmacy Representative
HEPCare Pharmacy
Imtiaz Alam, Owner
(512) 381-1708
Signed By Date
10/26/2016
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