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LARSON'S PHARMACY
CH0622370 SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
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Covered Entity Details
Entity Name
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Subdivision Name
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Type
HRSA-Funded Health Center
340B ID
CH0622370
Entity Address
725 PATE STREET
ALBANY, TX 76430-2435
Grant Number
H80CS06460
Participating Start Date
12/16/2005
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
LARSON'S PHARMACY
Pharmacy Address
BIG COUNTRY ENTERPRISES, INC.
109 NE 2ND ST
CROSS PLAINS, TX 76443-2401
Pharmacy Comments
Contract Details
Approval Date
1/9/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Meagan Marshall, CEO
(325) 762-2447 Ext: 110
Contract Pharmacy Representative
Larson's
Rene Ramirez, Pharmacy Director
(432) 661-5285
Signed By Date
1/9/2018
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