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ANDERSON'S GIBSON PHARMACY
CHC26190-05 TYLER FAMILY CIRCLE OF CARE
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Covered Entity Details
Entity Name
TYLER FAMILY CIRCLE OF CARE
Subdivision Name
FAMILY Circle of Care Athens Clinic
Type
HRSA-Funded Health Center
340B ID
CHC26190-05
Entity Address
1001 N. Palestine St
Athens, TX 75751-2662
Grant Number
H80CS26190
Participating Start Date
10/1/2017
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
ANDERSON'S GIBSON PHARMACY
Pharmacy Address
600 S PALESTINE ST STE 100
ATHENS, TX 75751
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Adams, CEO
(903) 606-5099
Contract Pharmacy Representative
Gibson Prescription Pharmacy
Lisa Kocian, Owner
(903) 675-7069
Signed By Date
10/16/2017
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