Contract Pharmacy Details

WALGREEN CO.
CH0614320 LONE STAR COMMUNITY HEALTH CENTER, INC

Covered Entity Details

Entity Name

LONE STAR COMMUNITY HEALTH CENTER, INC

Subdivision Name

Lone Star Community Health Center, Inc.- Conroe

Type

HRSA-Funded Health Center

340B ID

CH0614320

Entity Address

605 South Conroe Medical Drive
Conroe, TX 77304

Grant Number

H80CS02451

Participating Start Date

4/1/2004

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #12165
3901 E. DAVIS ST.
CONROE, TX 77301

Pharmacy Comments

Contract Details

Approval Date

7/1/2022

Contract Begin Date

10/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/4/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Karen Harwell, Chief Executive Officer
(936) 539-4004

Contract Pharmacy Representative

Lone Star Community Health Center
Valerie Powell, Director of 340B Program
(936) 523-5253

Signed By Date

7/1/2022

340B Drug Pricing Program Database