Contract Pharmacy Details

WALGREEN CO.
RWI75219 Resource Center of Dallas

Covered Entity Details

Entity Name

Resource Center of Dallas

Subdivision Name

Type

Ryan White Part A

340B ID

RWI75219

Entity Address

2603 Inwood
Dallas, TX 75235

Grant Number

H89HA00002

Participating Start Date

7/1/2015

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 09410
1007 E TYLER ST
ATHENS, TX 75751

Pharmacy Comments

Contract Details

Approval Date

1/6/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Marisa Elliott, Chief Operating Officer
(214) 540-4454

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/6/2020

340B Drug Pricing Program Database