Contract Pharmacy Details

WALGREEN CO.
CH0627760 HEALTH CENTER OF SOUTHEAST TEXAS

Covered Entity Details

Entity Name

HEALTH CENTER OF SOUTHEAST TEXAS

Subdivision Name

Health Center of Southeast Texas

Type

HRSA-Funded Health Center

340B ID

CH0627760

Entity Address

307 N. William Barnett Ave.
Cleveland, TX 77327-4061

Grant Number

H80CS08770

Participating Start Date

1/1/2008

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #12165
3901 E. DAVIS ST.
CONROE, TX 77301

Pharmacy Comments

Contract Details

Approval Date

12/6/2012

Contract Begin Date

1/1/2013

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Maggie Estrada, COO
(281) 592-2224

Contract Pharmacy Representative

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

Signed By Date

10/26/2012

340B Drug Pricing Program Database