Contract Pharmacy Details

WALGREEN CO.
CHC07502-00 Legacy Community Health Services, Inc.

Covered Entity Details

Entity Name

Legacy Community Health Services, Inc.

Subdivision Name

Legacy Montrose Clinic

Type

HRSA-Funded Health Center

340B ID

CHC07502-00

Entity Address

1415 California St
Houston, TX 77006-2602

Grant Number

H80CS07502

Participating Start Date

10/1/2004

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 11465
3822 OLD SPANISH TRAIL
HOUSTON, TX 77021

Pharmacy Comments

Contract Details

Approval Date

7/16/2014

Contract Begin Date

10/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/23/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

Katy Caldwell, Executive Director
(832) 548-5050

Contract Pharmacy Representative

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

Signed By Date

7/16/2014

340B Drug Pricing Program Database