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HIGHLAND PARK CVS, L.L.C.
STD78754 The Wright House Wellness Center DBA ASHWELL
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Covered Entity Details
Entity Name
The Wright House Wellness Center DBA ASHWELL
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD78754
Entity Address
3100 Red River St.
STE 3
Austin, TX 78705
Grant Number
NH25PS005182
Participating Start Date
7/1/2018
Last Recertification Date
5/14/2024
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
CVS/PHARMACY # 17711
3300 N. ASHLAND AVE
CHICAGO, IL 60657
Pharmacy Comments
Contract Details
Approval Date
4/13/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Benjamin P Walker, Director
(512) 467-0088 Ext: 133
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/13/2022
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