Contract Pharmacy Details

WALGREEN CO.
RWI76201 Health Services of North Texas, Inc.

Covered Entity Details

Entity Name

Health Services of North Texas, Inc.

Subdivision Name

HSNT Administrative Office

Type

Ryan White Part A

340B ID

RWI76201

Entity Address

4401 N INTERSTATE 35
Unit 312
DENTON, TX 76207

Grant Number

H89HA00014

Participating Start Date

1/1/2003

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06759
4001 FM 2181
CORINTH, TX 76210

Pharmacy Comments

Contract Details

Approval Date

4/15/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/13/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Doreen Rue, CEO
(940) 381-1501 Ext: 3001

Contract Pharmacy Representative

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

Signed By Date

4/15/2020

340B Drug Pricing Program Database