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HEB PHARMACY #592
CH061949AP 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 Cedar Park
Type
HRSA-Funded Health Center
340B ID
CH061949AP
Entity Address
1401 Medical Pkwy, BLDG B STE 311
Cedar Park, TX 78613
Grant Number
H80CS04289
Participating Start Date
3/24/2020
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
HEB PHARMACY #592
Pharmacy Address
651 NORTH US HIGHWAY 183
LEANDER, TX 78641
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
HEB
Kimberly Lavrack, Director of Third Party
(210) 938-7344
Signed By Date
7/12/2024
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