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WALGREENS MAIL SERVICE, INC.
CH061949L LONE STAR CIRCLE OF CARE
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Covered Entity Details
Entity Name
LONE STAR CIRCLE OF CARE
Subdivision Name
Lone Star Circle of Care at Lake Aire Medical Center
Type
HRSA-Funded Health Center
340B ID
CH061949L
Entity Address
2423 Williams Drive
Georgetown, TX 78628-3200
Grant Number
H80CS04289
Participating Start Date
10/1/2009
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREENS MAIL SERVICE, INC.
Pharmacy Address
8350 S RIVER PARKWAY
TEMPE, AZ 85284
Pharmacy Comments
Contract Details
Approval Date
4/14/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Pete Perialas, CEO
(512) 686-0624
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/14/2013
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