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CYSTIC FIBROSIS SERVICES, LLC
STD18901 Novus Adult Care Services
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Covered Entity Details
Entity Name
Novus Adult Care Services
Subdivision Name
Doylestown Office
Type
Sexually Transmitted Diseases
340B ID
STD18901
Entity Address
11 Duane Road
Suite A
Doylestown, PA 18901
Grant Number
NH25PS005144
Participating Start Date
10/1/2019
Last Recertification Date
5/6/2024
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
8/5/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allen C Smith, owner
(610) 867-5365
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/10/2019
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