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Walgreens #21373
CH0622450 NORTH TEXAS AREA COMMUNITY HEALTH CENTERS INC
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Covered Entity Details
Entity Name
NORTH TEXAS AREA COMMUNITY HEALTH CENTERS INC
Subdivision Name
North Texas Area Community Health Centers, Inc.
Type
HRSA-Funded Health Center
340B ID
CH0622450
Entity Address
2332 Beverly Hills Drive
Fort Worth, TX 76114
Grant Number
H80CS06457
Participating Start Date
11/18/2005
Last Recertification Date
2/24/2025
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
4/4/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gerrie Whitaker, CEO
(817) 546-6478
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/4/2022
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