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WALGREENS MAIL SERVICE, INC.
DSH450124 Dell Seton Medical Center at The University of Texas
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Covered Entity Details
Entity Name
Dell Seton Medical Center at The University of Texas
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450124
Entity Address
1500 RED RIVER ST
AUSTIN, TX 78701
Medicare Provider Number
450124
Participating Start Date
3/11/2021
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
WALGREENS MAIL SERVICE, INC.
Pharmacy Address
8337 S PARK CIRCLE
ORLANDO, FL 32819-9049
Pharmacy Comments
Contract Details
Approval Date
4/5/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/27/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kate C. Henderson, VP-COO
(512) 324-1940
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/5/2013
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