Contract Pharmacy Details

Walgreens #21373
CHC28977-00 TRIANGLE AREA NETWORK, INC.

Covered Entity Details

Entity Name

TRIANGLE AREA NETWORK, INC.

Subdivision Name

Triangle Area Network - Orange

Type

HRSA-Funded Health Center

340B ID

CHC28977-00

Entity Address

3727 N. 16th St.
Orange, TX 77632

Grant Number

H80CS28977

Participating Start Date

4/1/2017

Last Recertification Date

2/17/2025

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

4/13/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Dena Gray Hughes, CEO
(409) 832-8338 Ext: 222

Contract Pharmacy Representative

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

Signed By Date

4/13/2022

340B Drug Pricing Program Database