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LAUREL HEIGHTS PHARMACY
STD782122 BEAT AIDS Coalition Trust
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Covered Entity Details
Entity Name
BEAT AIDS Coalition Trust
Subdivision Name
Your Choice Clinic
Type
Sexually Transmitted Diseases
340B ID
STD782122
Entity Address
230 E Fredericksburg Rd
San Antonio, TX 78212
Grant Number
NU65PS923645
Participating Start Date
7/1/2018
Last Recertification Date
5/23/2025
Pharmacy Details
Pharmacy Name
LAUREL HEIGHTS PHARMACY
Pharmacy Address
2602 N MAIN AVE
SAN ANTONIO, TX 78212
Pharmacy Comments
Contract Details
Approval Date
5/2/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/9/2023
Ownership change
Contacts
Covered Entity Signing Official
MICHELE DURHAM, EXECUTIVE DIRECTOR
(210) 212-2266 Ext: 102
Contract Pharmacy Representative
Lifecare Pharmay Network
Zina Guerra, Admin Assistant
(210) 881-0890
Signed By Date
4/13/2018
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