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CYSTIC FIBROSIS SERVICES, LLC
HV616561 University of IL College of Medicine at Peoria
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Covered Entity Details
Entity Name
University of IL College of Medicine at Peoria
Subdivision Name
Positive Health Solutions
Type
Ryan White Part C
340B ID
HV616561
Entity Address
222 NE Monroe
Suite 904
PEORIA, IL 61602
Grant Number
H76HA00519
Participating Start Date
10/1/2002
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
4/11/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joanna Groden, Vice Chancellor for Research
(312) 996-2862
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/11/2019
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