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CYSTIC FIBROSIS SERVICES, LLC
STD337563 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 1b
Type
Sexually Transmitted Diseases
340B ID
STD337563
Entity Address
1300 S. Fort Harrison Ave., Ste. 100
Clearwater, FL 33756
Grant Number
H25PS005131
Participating Start Date
10/1/2021
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
WellPartner
Anthony McEeachern, Anthony McEachern
(315) 314-1802
Signed By Date
1/7/2022
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