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CYSTIC FIBROSIS SERVICES, LLC
STD322077 University of Florida CARES
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Covered Entity Details
Entity Name
University of Florida CARES
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD322077
Entity Address
4555 Emerson St.
120
Jacksonville, FL 32207
Grant Number
NH25PS005131
Participating Start Date
1/1/2020
Last Recertification Date
5/16/2022
Entity Termination Date
1/1/2023
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
10/31/2020
Contract Begin Date
11/10/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Tina M. Bottini, Senior Asst. Dean, Research
(904) 244-9478
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/31/2020
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