340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
METHODIST COMMUNITY PHARMACY - CHARLTON
DSH450051 METHODIST DALLAS MEDICAL CENTER
Print
Covered Entity Details
Entity Name
METHODIST DALLAS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450051
Entity Address
1441 NORTH BECKLEY AVENUE
DALLAS, TX 75203
Medicare Provider Number
450051
Participating Start Date
7/1/2005
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
METHODIST COMMUNITY PHARMACY - CHARLTON
Pharmacy Address
METHODIST COMMUNITY PHARMACY LLC
3500 W WHEATLAND RD STE B
DALLAS, TX 75237-3460
Pharmacy Comments
Contract Details
Approval Date
1/3/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jon T Albrecht, Corporate VP, Chief Pharmacy Officer
(214) 947-2504
Contract Pharmacy Representative
Methodist Health System
Jon T Albrecht, Corporate VP, Chief Pharmacy Officer
(214) 947-2504
Signed By Date
1/3/2020
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