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CYSTIC FIBROSIS SERVICES, LLC
CH081890 COMMUNITY HEALTH CENTER OF THE BLACK HILLS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF THE BLACK HILLS, INC.
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH081890
Entity Address
350 Pine Street
RAPID CITY, SD 57701
Grant Number
H80CS00216
Participating Start Date
1/1/2007
Last Recertification Date
2/12/2025
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
4/9/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/31/2019
Agreement registered in error
Contacts
Covered Entity Signing Official
JAMIE DAHLMAN, FINANCE DIRECTOR
(605) 721-8939 Ext: 204
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/9/2019
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