Contract Pharmacy Details

WALGREEN CO.
CH06084A SU CLINICA FAMILIAR

Covered Entity Details

Entity Name

SU CLINICA FAMILIAR

Subdivision Name

MULTI-SPECIALTY PRIMARY CARE

Type

HRSA-Funded Health Center

340B ID

CH06084A

Entity Address

1706 TREASURE HILLS BLVD
HARLINGEN, TX 78550

Grant Number

H80CS00348

Participating Start Date

12/1/1992

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #15381
1921 S 77 SUNSHINE STRIP
HARLINGEN, TX 78550

Pharmacy Comments

Contract Details

Approval Date

1/14/2016

Contract Begin Date

4/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

ELENA MARIN, CEO
(956) 365-6010 Ext: 1330

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/14/2016

340B Drug Pricing Program Database