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WALGREEN CO.
FP762013 HEALTH SERVICES OF NORTH TEXAS, INC.
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Covered Entity Details
Entity Name
HEALTH SERVICES OF NORTH TEXAS, INC.
Subdivision Name
HSNT at Serve Denton - L288
Type
Family Planning (Title X only)
340B ID
FP762013
Entity Address
306 N Loop 288
200
Denton, TX 76209
Grant Number
FPHPA006521
Participating Start Date
10/1/2015
Last Recertification Date
5/12/2022
Entity Termination Date
7/1/2023
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
7/9/2020
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
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