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CYSTIC FIBROSIS SERVICES, LLC
CHC26565-00 Hamdard Health Alliance
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Covered Entity Details
Entity Name
Hamdard Health Alliance
Subdivision Name
Hamdard Health Addison
Type
HRSA-Funded Health Center
340B ID
CHC26565-00
Entity Address
228 E Lake St
Addison, IL 60101-2889
Grant Number
H80CS26565
Participating Start Date
4/1/2014
Last Recertification Date
2/11/2025
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
7/12/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kiran S. Siddique, COO
(773) 465-4600 Ext: 227
Contract Pharmacy Representative
Walgreen
Amy Hartnett, Region Account Manager
(847) 282-2264
Signed By Date
7/12/2022
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