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CYSTIC FIBROSIS SERVICES, LLC
CH030720 EASTERN SHORE RURAL HEALTH SYSTEM, INC
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Covered Entity Details
Entity Name
EASTERN SHORE RURAL HEALTH SYSTEM, INC
Subdivision Name
Eastern Shore Rural Health System, Inc.
Type
HRSA-Funded Health Center
340B ID
CH030720
Entity Address
20280 Market St
Onancock, VA 23417
Grant Number
H80CS00791
Participating Start Date
10/1/1999
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
1/25/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeannette Edwards, CEO-Intrim
(757) 414-0400 Ext: 1112
Contract Pharmacy Representative
Eastern Shore Rural Health System, Inc.
KIMBERLY Bloxom SAVAGE, CHIEF COMPLIANCE OFFICER
(757) 414-0400 Ext: 108
Signed By Date
1/25/2023
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