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CYSTIC FIBROSIS SERVICES, LLC
DSH180040 UofL Health -- Louisville
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Covered Entity Details
Entity Name
UofL Health -- Louisville
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180040
Entity Address
200 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202-1818
Medicare Provider Number
180040
Participating Start Date
12/6/2005
Last Recertification Date
8/31/2024
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
10/20/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Steve Amsler, Senior Vice President of Operations
(502) 562-4122
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/20/2020
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