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CYSTIC FIBROSIS SERVICES, LLC
CAH181302-00 JAMES B HAGGIN MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
JAMES B HAGGIN MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH181302-00
Entity Address
464 LINDEN AVENUE
HARRODSBURG, KY 40330
Medicare Provider Number
181302
Participating Start Date
1/1/2016
Last Recertification Date
8/14/2024
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
4/10/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lynne Warner Lynn, Hospital Administrator
(859) 239-2329
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/10/2019
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