Contract Pharmacy Details

WAL-MART PHARMACY 10-0467
RWI76201 Health Services of North Texas, Inc.

Covered Entity Details

Entity Name

Health Services of North Texas, Inc.

Subdivision Name

HSNT Administrative Office

Type

Ryan White Part A

340B ID

RWI76201

Entity Address

4401 N INTERSTATE 35
Unit 312
DENTON, TX 76207

Grant Number

H89HA00014

Participating Start Date

1/1/2003

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-0467

Pharmacy Address

1515 SOUTH LOOP 288
DENTON, TX 76208

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

6/21/2021
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

340B Drug Pricing Program Database