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ADVANCECARE DALLAS
STD331395 Folx Foundation, Inc.
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Covered Entity Details
Entity Name
Folx Foundation, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD331395
Entity Address
407 Lincoln Road
Suite 6-B
Miami Beach, FL 33139
Grant Number
H25PS005131
Participating Start Date
9/23/2022
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
ADVANCECARE DALLAS
Pharmacy Address
3818 CEDAR SPRINGS RD STE 104
DALLAS, TX 75219
Pharmacy Comments
Contract Details
Approval Date
3/7/2023
Contract Begin Date
3/8/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Katie Runnells, Director
(310) 466-0897
Contract Pharmacy Representative
AdvanceCare Pharmacy
Kyle Bernier, Director of Operations
(508) 971-8380
Signed By Date
3/7/2023
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