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WALGREEN CO.
RWII762011B Health Services of North Texas, Inc.
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Covered Entity Details
Entity Name
Health Services of North Texas, Inc.
Subdivision Name
HSNT Denton Medical Center 4304
Type
Ryan White Part B
340B ID
RWII762011B
Entity Address
4304 Mesa Drive
Denton, TX 76207-3434
Grant Number
X07HA00054
Participating Start Date
10/1/2020
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06759
4001 FM 2181
CORINTH, TX 76210
Pharmacy Comments
Contract Details
Approval Date
8/28/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/25/2021
Agreement registered in error
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
7/15/2020
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