Contract Pharmacy Details

CENTERWELL PHARMACY, INC.
RWII75219 Resource Center of Dallas

Covered Entity Details

Entity Name

Resource Center of Dallas

Subdivision Name

Type

Ryan White Part B

340B ID

RWII75219

Entity Address

2701 Reagan Street
Dallas, TX 75219

Grant Number

X07HA00054

Participating Start Date

7/1/2015

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

CENTERWELL PHARMACY, INC.

Pharmacy Address

11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDO, FL 32824

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

CenterWell Pharmacy
Jay Duprey, ASSOCIATE DIRECTOR, CHANNEL DEVELOPMENT
(248) 921-7578

Signed By Date

7/15/2024

340B Drug Pricing Program Database