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CYSTIC FIBROSIS SERVICES, LLC
CH05320P HealthNet, Inc.
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Covered Entity Details
Entity Name
HealthNet, Inc.
Subdivision Name
Interfaith Hospitality Network
Type
HRSA-Funded Health Center
340B ID
CH05320P
Entity Address
1850 N Arsenal Ave
Indianapolis, IN 46218-4237
Grant Number
H80CS00114
Participating Start Date
4/1/2014
Last Recertification Date
2/25/2025
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
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Varon Edward Cantrell, Chief Medical Officer
(317) 957-2015
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/13/2023
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