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CYSTIC FIBROSIS SERVICES, LLC
CH011990 BLACKSTONE VALLEY COMMUNITY HEALTH CARE
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Covered Entity Details
Entity Name
BLACKSTONE VALLEY COMMUNITY HEALTH CARE
Subdivision Name
Blackstone Valley Community Health Care
Type
HRSA-Funded Health Center
340B ID
CH011990
Entity Address
39 EAST AVENUE
PAWTUCKET, RI 02860
Grant Number
H80CS00154
Participating Start Date
10/1/2003
Last Recertification Date
2/10/2025
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
Raymond Joseph Lavoie, EXECUTIVE DIRECTOR
(401) 729-5235
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/10/2019
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