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CYSTIC FIBROSIS SERVICES, LLC
CAH171350-00 Russell Regional Hospital
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Covered Entity Details
Entity Name
Russell Regional Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171350-00
Entity Address
200 S. Main Street
Russell, KS 67665
Medicare Provider Number
171350
Participating Start Date
7/1/2014
Last Recertification Date
8/12/2024
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
1/11/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sharon J Collins, CEO
(785) 483-0708
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/11/2021
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