340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CYSTIC FIBROSIS SERVICES, LLC
SCH520011-00 LAKEVIEW MEDICAL CENTER OF RICE LAKE
Print
Covered Entity Details
Entity Name
LAKEVIEW MEDICAL CENTER OF RICE LAKE
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH520011-00
Entity Address
1700 WEST STOUT STREET
RICE LAKE, WI 54868
Medicare Provider Number
520011
Participating Start Date
10/1/2023
Last Recertification Date
8/21/2024
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
8/18/2021
Contract Begin Date
8/18/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/15/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Bradley Groseth, Chief Administrative Officer
(715) 236-6131
Contract Pharmacy Representative
Walgreens
Karl Meehan, VP Health System Programs
(847) 315-2663
Signed By Date
8/9/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session