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CYSTIC FIBROSIS SERVICES, LLC
CH030990 MONROE CO. HEALTH CENTER
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Covered Entity Details
Entity Name
MONROE CO. HEALTH CENTER
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH030990
Entity Address
200 HEALTH CENTER DRIVE
UNION, WV 24983
Grant Number
H80CS00384
Participating Start Date
4/1/2004
Last Recertification Date
2/19/2025
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
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jim Nelson, CEO
(304) 772-3064 Ext: 129
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/12/2019
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