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CH061949AX Lone Star Circle Of Care (Active)
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Main Details
Name
Lone Star Circle Of Care
Subdivision Name
Lone Star Circle of Care Pediatrics at MoPac North
Type
HRSA-Funded Health Center
Site ID
BPS-H80-034200
340B ID
CH061949AX
Grant Number
H80CS04289
Additional Details
Current Program Status
Active
Registration Date
4/1/2022
Participating Start Date
4/7/2022
Participating Approval Date
4/4/2022
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
Lone Star Circle of Care
Jon Calvin, CEO
(512) 686-0523 Ext: 10451
Primary Contact
Lone Star Circle of Care
Corbin Ferrell, Director of Pharmacy Operations
(512) 686-0155 Ext: 3
Addresses
Street Address
12201 Renfert Way STE 105
Austin, TX 78758-5362
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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