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WALGREEN CO.
CH061010 MARTIN LUTHER KING JR FAMILY CLINIC INC
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Covered Entity Details
Entity Name
MARTIN LUTHER KING JR FAMILY CLINIC INC
Subdivision Name
MARTIN LUTHER KING, JR. FAMILY CLINIC, INC. dba Foremost Family Health Centers
Type
HRSA-Funded Health Center
340B ID
CH061010
Entity Address
2922B Martin Luther King Jr Blvd
Dallas, TX 75215
Grant Number
H80CS00127
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04203
438 W. ILLINOIS AVE.
DALLAS, TX 75224
Pharmacy Comments
Contract Details
Approval Date
4/21/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joyce Tapley, Chief Executive Officer
(214) 426-3645 Ext: 145
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/21/2014
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