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WAL-MART PHARMACY 10-4627
RWII762011 Health Services of North Texas, Inc.
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Covered Entity Details
Entity Name
Health Services of North Texas, Inc.
Subdivision Name
HSNT Denton Medical Center 4308
Type
Ryan White Part B
340B ID
RWII762011
Entity Address
4308 Mesa Drive
DENTON, TX 76207
Grant Number
X07HA00054
Participating Start Date
1/1/2003
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4627
Pharmacy Address
2750 W UNIVERSITY DR
DENTON, TX 76201
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/25/2021
Agreement registered in error
Contacts
Covered Entity Signing Official
Doreen Rue, CEO
(940) 381-1501 Ext: 3001
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/15/2020
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