340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
FIRST PHARMACY PAVILION
PED453316-10 Children’s Medical Center Plano
Print
Covered Entity Details
Entity Name
Children’s Medical Center Plano
Subdivision Name
Children's Health Specialty Center Plano Campus / Special Procedure
Type
Children's Hospital
340B ID
PED453316-10
Entity Address
7609 Preston Road
P2300
Plano, TX 75024-3214
Medicare Provider Number
453316
Outpatient Facility Provider Number
Participating Start Date
4/1/2017
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
FIRST PHARMACY PAVILION
Pharmacy Address
CHILDREN'S HEALTH SYSTEMS OF TEXAS
2350 N STEMMONS FWY # F1510
DALLAS, TX 75207
Pharmacy Comments
Contract Details
Approval Date
1/2/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David T Berry, CHST President, System Clinical Operations
(214) 456-2143
Contract Pharmacy Representative
Children's Medical Center Dallas
David LaVecchia, Retail Pharmacy Manager
(214) 456-3212
Signed By Date
1/2/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session