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YOAKUM DISCOUNT PHARMACY
CAH451346-00 YOAKUM COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
YOAKUM COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH451346-00
Entity Address
1200 CARL RAMERT DR
YOAKUM, TX 77995-0753
Medicare Provider Number
451346
Participating Start Date
7/1/2016
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
YOAKUM DISCOUNT PHARMACY
Pharmacy Address
1200 CARL RAMERT DR
STE A
YOAKUM, TX 77995-4868
Pharmacy Comments
Contract Details
Approval Date
1/17/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Olivares, CFO
(361) 293-2321 Ext: 104
Contract Pharmacy Representative
Kelli Schley, Owner
(361) 293-6881
Signed By Date
1/17/2017
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