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HEB PHARMACY WAREHOUSE 208
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
HEB PHARMACY WAREHOUSE 208
Pharmacy Address
H-E-B, LP
5311 DIETRICH RD STE 100
SAN ANTONIO, TX 78219
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marisa Elliott, Chief Operating Officer
(214) 540-4454
Contract Pharmacy Representative
HEB
Kimberly Lavrack, Director of Third Party
(210) 938-7344
Signed By Date
7/15/2024
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