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OPTION CARE ENTERPRISES, INC.
HM1592 CHILDREN'S MEDICAL CENTER OF DALLAS
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Covered Entity Details
Entity Name
CHILDREN'S MEDICAL CENTER OF DALLAS
Subdivision Name
NORTH TEXAS HEMOPHILIA CENTER
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM1592
Entity Address
1935 Medical District Drive
DALLAS, TX 75235
Grant Number
5H30MC24051-13-00
Participating Start Date
10/1/1996
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
OPTION CARE ENTERPRISES, INC.
Pharmacy Address
OPTION CARE
6611 N. BELTLINE RD.
SUITE 100
IRVING, TX 75063-6001
Pharmacy Comments
Contract Details
Approval Date
10/8/2019
Contract Begin Date
1/1/2020
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
Option Care
Derek Bilyk, Program Manager, Health Systems
(224) 813-1283
Signed By Date
10/8/2019
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