Pharmacy Details

KROGER SPECIALTY PHARMACY TX - information as of 5/29/2025 2:25:10 AM

Name
KROGER SPECIALTY PHARMACY TX

Address

4280 KELLWAY CIR
ADDISON, TX 75001-4200

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	DSH050262	RONALD REAGAN UCLA MEDICAL CENTER		Disproportionate Share Hospital	757 WESTWOOD PLAZA		LOS ANGELES	CA	04/01/2019	10/30/2020	12/14/2020 1:17 PM
Details	DSH320021	PRESBYTERIAN HOSPITAL		Disproportionate Share Hospital	1100 CENTRAL AVENUE SE		ALBUQUERQUE	NM	04/01/2019	10/09/2019	10/25/2019 2:22 PM
Details	SCH450010-00	United Regional Health Care System		Sole Community Hospital	1600 11th Street		Wichita Falls	TX	04/01/2020	10/30/2020	10/30/2020 12:01 AM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			KROGER SPECIALTY PHARMACY TX 4280 KELLWAY CIR ADDISON, TX 75001-4200	12/4/2019 4:08 PM
Addresses	Pharmacy Address	Insert			KROGER SPECIALTY PHARMACY TX 4280 KELLWAY CIRCLE ADDISON, TX 75001	3/1/2018 12:11 PM
Details	Name	Update		KROGER SEPCIALTY PHARMACY TX	KROGER SPECIALTY PHARMACY TX	3/1/2018 12:11 PM
Addresses	Pharmacy Address	Insert			KROGER SEPCIALTY PHARMACY TX 4280 KELLWAY CIRCLE ADDISON, TX 75001	9/29/2017 6:44 AM
Addresses	Pharmacy Address	Update		TOTAL LIFE CARE RX PHARMACY LLC 4280 KELLWAY CIRCLE ADDISON, TX 75001	KROGER SEPCIALTY PHARMACY TX 4280 KELLWAY CIRCLE ADDISON, TX 75001	11/14/2016 2:56 PM
Details	Name	Update		TOTAL LIFE CARE RX PHARMACY LLC	KROGER SEPCIALTY PHARMACY TX	11/14/2016 2:56 PM
Details	Comments	Insert				3/16/2015 10:36 AM
Details	Is Deleted	Insert			False	3/16/2015 10:36 AM
Addresses	Pharmacy Address	Insert			TOTAL LIFE CARE RX PHARMACY LLC 4280 KELLWAY CIRCLE ADDISON, TX 75001	3/16/2015 10:36 AM
Details	Name	Insert			TOTAL LIFE CARE RX PHARMACY LLC	3/16/2015 10:36 AM