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CYSTIC FIBROSIS SERVICES, LLC
CH02071C CITY OF NEWARK, NEW JERSEY
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Covered Entity Details
Entity Name
CITY OF NEWARK, NEW JERSEY
Subdivision Name
Mary Eliza Mahoney Health Center Mobile Medical Unit
Type
HRSA-Funded Health Center
340B ID
CH02071C
Entity Address
394 UNIVERSITY AVE
NEWARK, NJ 07102-1221
Grant Number
H80CS00009
Participating Start Date
4/1/2018
Last Recertification Date
2/11/2025
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
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
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