Contract Pharmacy Details

CVS PHARMACY, INC.
STD75235 Resource Center of Dallas

Covered Entity Details

Entity Name

Resource Center of Dallas

Subdivision Name

Nelson-Tebedo Clinic

Type

Sexually Transmitted Diseases

340B ID

STD75235

Entity Address

2603 Inwood
Dallas, TX 75235

Grant Number

NH25PS005182

Participating Start Date

4/1/2017

Last Recertification Date

5/5/2025

Pharmacy Details

Pharmacy Name

CVS PHARMACY, INC.

Pharmacy Address

DBA: CVS/PHARMACY # 06865
1099 W. MAIN STREET
LEWISVILLE, TX 75067

Pharmacy Comments

Contract Details

Approval Date

4/6/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Marisa Elliott, Chief Operating Officer
(214) 540-4454

Contract Pharmacy Representative

CVS Health
Christian Reid, 340B Program Director
(401) 770-2118

Signed By Date

4/6/2023

340B Drug Pricing Program Database