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DELIVERCARERX PHARMACY LLC
CH061730 GULF COAST HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
GULF COAST HEALTH CENTER, INC.
Subdivision Name
GULF COAST HEALTH CENTER, INC. - PORT ARTHUR
Type
HRSA-Funded Health Center
340B ID
CH061730
Entity Address
2548 Memorial Blvd
Port Arthur, TX 77640-2825
Grant Number
H80CS00408
Participating Start Date
7/1/1997
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
DELIVERCARERX PHARMACY LLC
Pharmacy Address
DELIVERCARERX PHARMACY LLC
1471 E BUSINESS CENTER DR
STE 200
MT PROSPECT, IL 60056
Pharmacy Comments
Contract Details
Approval Date
4/5/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marsha E. Thigpen, Executive Director
(409) 983-1161 Ext: 880
Contract Pharmacy Representative
Agape
Dave Krishna, CEO
(847) 965-1600
Signed By Date
4/5/2018
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