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RENUE RX #1
CHC24197-05 Health Services of North Texas, Inc.
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Covered Entity Details
Entity Name
Health Services of North Texas, Inc.
Subdivision Name
HSNT Wylie Children's Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CHC24197-05
Entity Address
303 S Highway 78
Ste 106
Wylie, TX 75098
Grant Number
H80CS24197
Participating Start Date
1/1/2018
Last Recertification Date
2/23/2025
Pharmacy Details
Pharmacy Name
RENUE RX #1
Pharmacy Address
RENUE RX #2- TELP (REMOTE SITE)
5501 INDEPENDENCE PKWY STE 110-B
PLANO, TX 75023-5463
Pharmacy Comments
Contract Details
Approval Date
10/13/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Doreen Rue, CEO
(940) 381-1501 Ext: 3001
Contract Pharmacy Representative
Renue RX #1
Raj M Chhadua, Managing Partner/CEO
(214) 422-2598
Signed By Date
10/13/2021
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