Contract Pharmacy Details

CVS PHARMACY, INC.
STD75235 Resource Center of Dallas

Covered Entity Details

Entity Name

Resource Center of Dallas

Subdivision Name

Nelson-Tebedo Clinic

Type

Sexually Transmitted Diseases

340B ID

STD75235

Entity Address

2603 Inwood
Dallas, TX 75235

Grant Number

NH25PS005182

Participating Start Date

4/1/2017

Last Recertification Date

5/5/2025

Pharmacy Details

Pharmacy Name

CVS PHARMACY, INC.

Pharmacy Address

DBA CVS/PHARMACY #10758
2501 N FIELD STREET
DALLAS, TX 75201

Pharmacy Comments

Contract Details

Approval Date

7/3/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Marisa Elliott, Chief Operating Officer
(214) 540-4454

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/3/2018

340B Drug Pricing Program Database