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WALGREEN CO.
STD787041 Texas Health Action
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Covered Entity Details
Entity Name
Texas Health Action
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD787041
Entity Address
2800 S. IH-35
103
Austin, TX 78704
Grant Number
NH25PS005182
Participating Start Date
4/1/2020
Last Recertification Date
5/28/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04704
4501 GUADALUPE ST.
AUSTIN, TX 78751
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher M Hamilton, CEO
(512) 647-6512
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2020
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