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WAL-MART PHARMACY 10-4627
RWII762011A 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 South Center
Type
Ryan White Part B
340B ID
RWII762011A
Entity Address
3537 South I35E
Suite 210
Denton, TX 76210-6869
Grant Number
X07HA00054
Participating Start Date
10/1/2020
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4627
Pharmacy Address
2750 W UNIVERSITY DR
DENTON, TX 76201
Pharmacy Comments
Contract Details
Approval Date
8/28/2020
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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