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WALGREENS SPECIALTY PHARMACY, LLC
CH045207CT CUMBERLAND FAMILY MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
CUMBERLAND FAMILY MEDICAL CENTER, INC.
Subdivision Name
Bardstown Career and Technology Healthy Kids Clinic
Type
HRSA-Funded Health Center
340B ID
CH045207CT
Entity Address
420 N 5th St
Bardstown, KY 40004-1616
Grant Number
H80CS08218
Participating Start Date
1/1/2019
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15443
10530 JOHN W ELLIOTT DR STE 100
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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