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WALGREEN CO.
STD761075 TARRANT COUNTY PUBLIC HEALTH
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Covered Entity Details
Entity Name
TARRANT COUNTY PUBLIC HEALTH
Subdivision Name
STD Division
Type
Sexually Transmitted Diseases
340B ID
STD761075
Entity Address
1101 SOUTH MAIN STREET
Suite 1500A
FORT WORTH, TX 76104-4802
Grant Number
NH25PS005182
Participating Start Date
10/1/2016
Last Recertification Date
5/15/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04132
780 W. BEDFORD EULESS RD.
HURST, TX 76053
Pharmacy Comments
Contract Details
Approval Date
10/11/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ann Salyer-Caldwell, Deputy Director
(817) 321-5309
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/11/2017
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