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KROGER PHARMACY #136
CH0614320 LONE STAR COMMUNITY HEALTH CENTER, INC
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Covered Entity Details
Entity Name
LONE STAR COMMUNITY HEALTH CENTER, INC
Subdivision Name
Lone Star Community Health Center, Inc.- Conroe
Type
HRSA-Funded Health Center
340B ID
CH0614320
Entity Address
605 South Conroe Medical Drive
Conroe, TX 77304
Grant Number
H80CS02451
Participating Start Date
4/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #136
Pharmacy Address
341 S LOOP 336 W
CONROE, TX 77304
Pharmacy Comments
Contract Details
Approval Date
7/16/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen Harwell, Chief Executive Officer
(936) 539-4004
Contract Pharmacy Representative
Lone Star Community Health Center
Valerie Powell, Director of 340B Program
(936) 523-5253
Signed By Date
7/16/2018
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