340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
STD75235 Resource Center of Dallas
Print
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
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
10/3/2023
Contract Begin Date
1/1/2024
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
10/3/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session