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CYSTIC FIBROSIS SERVICES, LLC
CH086120 COMMUNITY HEALTH CENTER OF CENTRAL WYOMING, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF CENTRAL WYOMING, INC.
Subdivision Name
Community Health Center of Central Wyoming
Type
HRSA-Funded Health Center
340B ID
CH086120
Entity Address
5000 Blackmore Road
Casper, WY 82609
Grant Number
H80CS00564
Participating Start Date
1/1/2001
Last Recertification Date
2/18/2025
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
Carl J Harris, CEO
(307) 233-6000 Ext: 6022
Contract Pharmacy Representative
Community Health Center of Central Wyoming
Michelle Carpenter, Pharmacy Manager
(307) 233-6050
Signed By Date
1/7/2022
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