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THE MEDICINE SHOPPE #708
STD75092 Your Health Clinic
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Covered Entity Details
Entity Name
Your Health Clinic
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD75092
Entity Address
1521 Baker Road
Sherman, TX 75090
Grant Number
NH25PS005182
Participating Start Date
1/1/2016
Last Recertification Date
5/8/2025
Pharmacy Details
Pharmacy Name
THE MEDICINE SHOPPE #708
Pharmacy Address
1624 N. TRAVIS ST.
SHERMAN, TX 75092-3762
Pharmacy Comments
Contract Details
Approval Date
10/9/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gwynne Palmore, Executive Director
(903) 891-1972
Contract Pharmacy Representative
Nota Consulting Group, LLC
Fungisai Nota, 340B Program Manager
(610) 742-7763
Signed By Date
10/9/2017
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