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WALGREEN CO.
CH061949AB 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 Stassney
Type
HRSA-Funded Health Center
340B ID
CH061949AB
Entity Address
730 W Stassney Ln Ste 110
Austin, TX 78745
Grant Number
H80CS04289
Participating Start Date
10/1/2016
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04458
3601 W WILLIAM CANNON DR.
AUSTIN, TX 78749
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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