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RANDALLS FOOD AND DRUGS LP
DSH450330 OAKBEND MEDICAL CENTER
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Covered Entity Details
Entity Name
OAKBEND MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450330
Entity Address
1705 JACKSON ST
RICHMOND, TX 77469
Medicare Provider Number
450330
Participating Start Date
1/1/2024
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
RANDALLS FOOD AND DRUGS LP
Pharmacy Address
RANDALLS PHARMACY #1011
14610 MEMORIAL DR
HOUSTON, TX 77079
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/11/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jeffrey Hammel, CFO
(281) 341-4881
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
10/16/2017
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