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CYSTIC FIBROSIS SERVICES, LLC
DSH390114 UPMC Magee-Womens Hospital
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Covered Entity Details
Entity Name
UPMC Magee-Womens Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390114
Entity Address
300 HALKET STREET
PITTSBURGH, PA 15213
Medicare Provider Number
390114
Participating Start Date
4/1/2003
Last Recertification Date
8/29/2024
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
7/12/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/19/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ron Wesley Deems, CFO Mercy and Magee
(412) 576-8808
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/12/2022
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