340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CYSTIC FIBROSIS SERVICES, LLC
CAH371309-01 PAWHUSKA HOSPITAL INC.
Print
Covered Entity Details
Entity Name
PAWHUSKA HOSPITAL INC.
Subdivision Name
PAWHUSKA FAMILY MEDICAL CLINIC - FAMILY MEDICINE
Type
Critical Access Hospital
340B ID
CAH371309-01
Entity Address
1109 E 15TH ST
Pawhuska, OK 74056
Medicare Provider Number
371309
Outpatient Facility Provider Number
378532
Participating Start Date
1/1/2022
Last Recertification Date
8/16/2024
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
1/14/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jason Timothy McBride, Administrator
(918) 287-3232
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/14/2022
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