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CYSTIC FIBROSIS SERVICES, LLC
RWII35233 Birmingham AIDS Outreach, Inc.
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Covered Entity Details
Entity Name
Birmingham AIDS Outreach, Inc.
Subdivision Name
Magic City Wellness Center
Type
Ryan White Part B
340B ID
RWII35233
Entity Address
3220 5th Avenue South
Suite 100
Birmingham, AL 35222
Grant Number
X07HA00049
Participating Start Date
10/1/2016
Last Recertification Date
2/13/2025
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
4/10/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KAREN MUSGROVE, EXECUTIVE DIRECTOR
(205) 322-4197
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/10/2019
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