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HEB PHARMACY #582
CH060810 COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.
Subdivision Name
COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.
Type
HRSA-Funded Health Center
340B ID
CH060810
Entity Address
228 Saint George St
Gonzales, TX 78629-3910
Grant Number
H80CS00125
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
HEB PHARMACY #582
Pharmacy Address
104 HASLER BLVD.
BASTROP, TX 78602
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Henry F. Salas, CEO
(830) 672-6511 Ext: 207
Contract Pharmacy Representative
HEB Pharmacy
Jay Beuche, Manager Contracting
(210) 938-8578
Signed By Date
1/12/2018
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