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CVS PHARMACY, INC.
CH061949AK Lone Star Circle Of Care
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Covered Entity Details
Entity Name
Lone Star Circle Of Care
Subdivision Name
Lone Star Circle of Care at Jonestown
Type
HRSA-Funded Health Center
340B ID
CH061949AK
Entity Address
18220 FM 1431 STE D
Jonestown, TX 78645
Grant Number
H80CS04289
Participating Start Date
1/1/2019
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 07827
1855 GATTIS SCHOOL RD
ROUND ROCK, TX 78664
Pharmacy Comments
Contract Details
Approval Date
7/12/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jon Calvin, CEO
(512) 686-0523 Ext: 10451
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/12/2024
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