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AMAZON PHARMACY #001
CHC28363-00 SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
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Covered Entity Details
Entity Name
SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
Subdivision Name
Longview Care Clinic
Type
HRSA-Funded Health Center
340B ID
CHC28363-00
Entity Address
409 N. 6th Street
LONGVIEW, TX 75601-6511
Grant Number
H80CS28363
Participating Start Date
7/1/2016
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
AMAZON PHARMACY #001
Pharmacy Address
4500 S PLEASANT VALLEY RD STE 201
AUSTIN, TX 78744-2911
Pharmacy Comments
Contract Details
Approval Date
1/15/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/12/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kim Nesvig, CEO
(903) 212-7811 Ext: 7811
Contract Pharmacy Representative
PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725
Signed By Date
1/15/2018
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