Contract Pharmacy Details

Walgreens #21373
CH063910 Community Health Development, Inc.

Covered Entity Details

Entity Name

Community Health Development, Inc.

Subdivision Name

Our Health/Nuestro Centro de Salud

Type

HRSA-Funded Health Center

340B ID

CH063910

Entity Address

200 Evans St.
Uvalde, TX 78801-5142

Grant Number

H80CS00130

Participating Start Date

12/1/1992

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

Walgreens #21373

Pharmacy Address

Walgreens Central Fill #21373
4100 Dale Earnhardt Way
STE 200
Northlake, TX 76262

Pharmacy Comments

Contract Details

Approval Date

2/15/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/15/2022
Agreement registered in error

Contacts

Covered Entity Signing Official

Mayela Castanon, Chief Executive Officer
(830) 278-5604 Ext: 3100

Contract Pharmacy Representative

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

Signed By Date

2/15/2022

340B Drug Pricing Program Database