Contract Pharmacy Details

THE MEDICINE SHOPPE #708
RWII75092 Your Health Clinic

Covered Entity Details

Entity Name

Your Health Clinic

Subdivision Name

Type

Ryan White Part B

340B ID

RWII75092

Entity Address

1521 Baker Road
Sherman, TX 75090

Grant Number

X07HA00054

Participating Start Date

7/1/2014

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

THE MEDICINE SHOPPE #708

Pharmacy Address

1624 N. TRAVIS ST.
SHERMAN, TX 75092-3762

Pharmacy Comments

Contract Details

Approval Date

7/10/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Gwynne Palmore, Executive Director
(903) 891-1972

Contract Pharmacy Representative

Nota Consulting Group, LLC
Fungisai Nota, 340B Program Manager
(610) 742-7763

Signed By Date

7/10/2019

340B Drug Pricing Program Database