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CVS PHARMACY, INC.
RWI75219 Resource Center of Dallas
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Covered Entity Details
Entity Name
Resource Center of Dallas
Subdivision Name
Type
Ryan White Part A
340B ID
RWI75219
Entity Address
2701 Reagan Street
Dallas, TX 75219
Grant Number
H89HA00002
Participating Start Date
7/1/2015
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
CVS PHARMACY # 16364
9440 MARSH LN
DALLAS, TX 75220
Pharmacy Comments
Contract Details
Approval Date
4/14/2023
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
4/14/2023
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