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ASPCARES
STD76140 COLLINS FAMILY PLANNING CLINIC
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Covered Entity Details
Entity Name
COLLINS FAMILY PLANNING CLINIC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD76140
Entity Address
1100 BRIDGEWOOD DR STE 120
Fort Worth, TX 76112
Grant Number
NH25PS005182
Participating Start Date
7/1/2018
Last Recertification Date
5/6/2025
Pharmacy Details
Pharmacy Name
ASPCARES
Pharmacy Address
1210 COTTONWOOD CREEK TRL STE 210
CEDAR PARK, TX 78613
Pharmacy Comments
Contract Details
Approval Date
1/10/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JANICE COLLINS, EXECUTIVE DIRECTOR
(817) 922-8182
Contract Pharmacy Representative
Elite Analytics Group, Inc
Rex Green, CEO
(469) 899-2293
Signed By Date
1/10/2020
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