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HEB PHARMACY #091
CHC24150-00 PEOPLE'S COMMUNITY CLINIC
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Covered Entity Details
Entity Name
PEOPLE'S COMMUNITY CLINIC
Subdivision Name
People's Community Clinic
Type
HRSA-Funded Health Center
340B ID
CHC24150-00
Entity Address
2909 North IH 35
Austin, TX 78722
Grant Number
H80CS24150
Participating Start Date
10/1/2012
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HEB PHARMACY #091
Pharmacy Address
2508 E RIVERSIDE DRIVE
AUSTIN, TX 78741
Pharmacy Comments
Contract Details
Approval Date
10/13/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Regina Rogoff, CEO
(512) 684-1721
Contract Pharmacy Representative
HEB Pharmacy
Jay Beuche, Manager Contracting
(210) 938-8578
Signed By Date
10/13/2017
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