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CYSTIC FIBROSIS SERVICES, LLC
FQHCLA119 Community Clinical Services, Inc.
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Covered Entity Details
Entity Name
Community Clinical Services, Inc.
Subdivision Name
B Street Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA119
Entity Address
57 Birch Street
Lewiston, ME 04240-7415
Grant Number
LALCS00085
Participating Start Date
4/1/2001
Last Recertification Date
3/3/2025
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
7/6/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joan Churchill, EXECUTIVE DIRECTOR/CFO
(207) 513-3897
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/6/2017
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