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WALGREEN CO.
CH061949AC 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 Northwest Austin
Type
HRSA-Funded Health Center
340B ID
CH061949AC
Entity Address
11111 Research Blvd Ste 320
Austin, TX 78759
Grant Number
H80CS04289
Participating Start Date
10/1/2017
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #10615
5345 N INTERSTATE 35
AUSTIN, TX 78723
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
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/12/2024
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