340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ROSE CITY PHARMACY
DSH450102 CHRISTUS MOTHER FRANCES HOSP-TYLER
Print
Covered Entity Details
Entity Name
CHRISTUS MOTHER FRANCES HOSP-TYLER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450102
Entity Address
800 EAST DAWSON
TYLER, TX 75701
Medicare Provider Number
450102
Participating Start Date
3/10/2022
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
ROSE CITY PHARMACY
Pharmacy Address
ROSE CITY PHARMACY LLC
2130 W GRANDE BLVD
TYLER, TX 75703-7576
Pharmacy Comments
Contract Details
Approval Date
1/11/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/17/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Eric Garrison, CFO
(903) 606-4102
Contract Pharmacy Representative
Rose City Pharmacy
Wilson Krezdorn, President
(903) 707-2034
Signed By Date
1/11/2024
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