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CYSTIC FIBROSIS SERVICES, LLC
CH045207GU Cumberland Family Medical Center, Inc.
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Covered Entity Details
Entity Name
Cumberland Family Medical Center, Inc.
Subdivision Name
Oakland Elementary Healthy Kids Clinic
Type
HRSA-Funded Health Center
340B ID
CH045207GU
Entity Address
2494 Church St
Oakland, KY 42159-6809
Grant Number
H80CS08218
Participating Start Date
4/1/2023
Last Recertification Date
2/18/2025
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
10/5/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ryan Smith, CFO
(270) 858-6655
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/5/2023
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