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WAL-MART PHARMACY 10-0249
CH0614320 LONE STAR COMMUNITY HEALTH CENTER, INC
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Covered Entity Details
Entity Name
LONE STAR COMMUNITY HEALTH CENTER, INC
Subdivision Name
Lone Star Community Health Center, Inc.- Conroe
Type
HRSA-Funded Health Center
340B ID
CH0614320
Entity Address
605 South Conroe Medical Drive
Conroe, TX 77304
Grant Number
H80CS02451
Participating Start Date
4/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0249
Pharmacy Address
831 HWY. 59 SOUTH
CLEVELAND, TX 77327
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen Harwell, Chief Executive Officer
(936) 539-4004
Contract Pharmacy Representative
Walmart
Nick Tallman, Sr. Director, Merchandise Operations – Pharmacy
(479) 371-0417
Signed By Date
1/15/2025
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