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WALGREEN CO.
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
2701 Reagan Street
Dallas, TX 75219
Grant Number
NH25PS005182
Participating Start Date
4/1/2018
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09015
4702 N JIM MILLER RD
DALLAS, TX 75227-2801
Pharmacy Comments
Contract Details
Approval Date
10/6/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marisa Elliott, Chief Operating Officer
(214) 540-4454
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/6/2021
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