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CYSTIC FIBROSIS SERVICES, LLC
STD337561 West Central Gastroenterology dba Gastro Florida
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Covered Entity Details
Entity Name
West Central Gastroenterology dba Gastro Florida
Subdivision Name
Gastro Florida Division 2
Type
Sexually Transmitted Diseases
340B ID
STD337561
Entity Address
508 Jeffords St Ste D
Clearwater, FL 33756
Grant Number
H25PS005131
Participating Start Date
1/1/2021
Last Recertification Date
5/23/2024
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
1/7/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Seena Salyani, CEO
(727) 347-0536
Contract Pharmacy Representative
Walgreens
Chris Sutter, Account Manager, Health Systems
(847) 612-0296
Signed By Date
1/7/2022
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