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CYSTIC FIBROSIS SERVICES, LLC
CH012080 COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
CHC of Middletown
Type
HRSA-Funded Health Center
340B ID
CH012080
Entity Address
675 Main St
Middletown, CT 06457
Grant Number
H80CS00326
Participating Start Date
4/1/2002
Last Recertification Date
2/14/2025
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
7/3/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mark Masselli, President and CEO
(860) 347-6971
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/3/2020
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