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WALGREEN CO.
CH066570 LA ESPERANZA CLINIC, INC.
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Covered Entity Details
Entity Name
LA ESPERANZA CLINIC, INC.
Subdivision Name
LA ESPERANZA CLINIC
Type
HRSA-Funded Health Center
340B ID
CH066570
Entity Address
1610 S Chadbourne St
San Angelo, TX 76903-8510
Grant Number
H80CS00203
Participating Start Date
7/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07293
12 N ABE STREET
SAN ANGELO, TX 76903-6361
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dean Munn, CEO
(325) 947-5600
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2019
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