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ABOUNDING PROSPERITY COMMUNITY PHARMACY
STD75219 Resource Center of Dallas
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Covered Entity Details
Entity Name
Resource Center of Dallas
Subdivision Name
Health Campus
Type
Sexually Transmitted Diseases
340B ID
STD75219
Entity Address
2603 Inwood
Dallas, TX 75235
Grant Number
NH25PS005182
Participating Start Date
4/1/2018
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
ABOUNDING PROSPERITY COMMUNITY PHARMACY
Pharmacy Address
AMERICAN STAR PHARMACY, INC
1705 MARTIN LUTHER KING JR BLVD STE A
DALLAS, TX 75215
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/26/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Marisa Elliott, Chief Operating Officer
(214) 540-4454
Contract Pharmacy Representative
Elite Analytics Group, Inc
Rex Green, CEO
(469) 899-2293
Signed By Date
10/15/2020
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