Contract Pharmacy Details

WALGREEN CO.
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

WALGREEN CO.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #15318
3826 CEDAR SPRINGS RD
DALLAS, TX 75219

Pharmacy Comments

Contract Details

Approval Date

5/26/2015

Contract Begin Date

7/1/2015

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Marisa Elliott, Chief Operating Officer
(214) 540-4454

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

5/26/2015

340B Drug Pricing Program Database