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CVS PHARMACY, INC.
STD752191 Texas Health Action
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Covered Entity Details
Entity Name
Texas Health Action
Subdivision Name
Kind Clinic
Type
Sexually Transmitted Diseases
340B ID
STD752191
Entity Address
3802 Cedar Springs Road
Dallas, TX 75219
Grant Number
NH25PS005182
Participating Start Date
7/1/2021
Last Recertification Date
5/28/2024
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 08384
851 S BELL BLVD
CEDAR PARK, TX 78613
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/12/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Chris Adams, CFO
(512) 643-8770
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2022
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