Contract Pharmacy Details

WALGREEN CO.
CH061230 CENTRO DE SALUD FAMILIAR LA FE, INC.

Covered Entity Details

Entity Name

CENTRO DE SALUD FAMILIAR LA FE, INC.

Subdivision Name

CENTRAL CLINIC

Type

HRSA-Funded Health Center

340B ID

CH061230

Entity Address

700 SOUTH OCHOA
EL PASO, TX 79901

Grant Number

H80CS00128

Participating Start Date

12/1/1992

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #12376
1432 ANTONIO ST.
ANTHONY, TX 79821

Pharmacy Comments

Contract Details

Approval Date

7/29/2015

Contract Begin Date

10/1/2015

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Salvador Balcorta, CEO
(915) 534-7979

Contract Pharmacy Representative

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

Signed By Date

7/29/2015

340B Drug Pricing Program Database