Contract Pharmacy Details

CYSTIC FIBROSIS SERVICES, LLC
CH02071B CITY OF NEWARK, NEW JERSEY

Covered Entity Details

Entity Name

CITY OF NEWARK, NEW JERSEY

Subdivision Name

Mary Eliza Mahoney Health Center @ 140 Bergen Street

Type

HRSA-Funded Health Center

340B ID

CH02071B

Entity Address

140 Bergen St
Newark, NJ 07103-2425

Grant Number

H80CS00009

Participating Start Date

4/1/2018

Last Recertification Date

2/27/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

CYSTIC FIBROSIS SERVICES, LLC

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #16280
10530 JOHN W ELLIOTT DR STE 200
FRISCO, TX 75033

Pharmacy Comments

Contract Details

Approval Date

10/15/2018

Contract Begin Date

1/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Mark J Wade, CEO
(973) 733-5310

Contract Pharmacy Representative

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

Signed By Date

10/15/2018

340B Drug Pricing Program Database