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CVS PHARMACY, INC.
STD761101 Health Education Learning Project
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Covered Entity Details
Entity Name
Health Education Learning Project
Subdivision Name
8th Avenue
Type
Sexually Transmitted Diseases
340B ID
STD761101
Entity Address
1919 8th Avenue
Fort Worth, TX 76110
Grant Number
NH25PS005182
Participating Start Date
10/1/2019
Last Recertification Date
5/14/2024
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 05695
815 E. ABRAMS ST.
ARLINGTON, TX 76010
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DeeJay Johannessen, Chief Executive Officer
(817) 332-7722
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2019
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