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CYSTIC FIBROSIS SERVICES, LLC
STD333112 WellView Care
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Covered Entity Details
Entity Name
WellView Care
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD333112
Entity Address
906 WEST SUNRISE BLVD
A
Fort Lauderdale, FL 33311
Grant Number
NH25PS005131
Participating Start Date
4/1/2021
Last Recertification Date
5/7/2024
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
9/27/2022
Contract Begin Date
9/27/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Adolfo Lorenzo, President
(305) 491-3600
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
9/27/2022
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