Contract Pharmacy Details

HEB PHARMACY #790
RWI75219 Resource Center of Dallas

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 #790

Pharmacy Address

6001 PRESTON RD
STE 100
PLANO, TX 75093

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

340B Drug Pricing Program Database