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LINO'S PHARMACY
SCH450654-00 STARR COUNTY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
STARR COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH450654-00
Entity Address
128 N FM 3167
RIO GRANDE CITY, TX 78582-6211
Medicare Provider Number
450654
Participating Start Date
1/1/2018
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
LINO'S PHARMACY
Pharmacy Address
708 N GRANT ST
ROMA, TX 78584
Pharmacy Comments
Contract Details
Approval Date
1/11/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eloy Garza, Assistant Administrator
(956) 487-9055
Contract Pharmacy Representative
Lino's Pharmacy
Jesus Rios, President
(956) 849-1811
Signed By Date
1/11/2018
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