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CYSTIC FIBROSIS SERVICES, LLC
STD333113 Care Resource Community Health Centers, Inc.
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Covered Entity Details
Entity Name
Care Resource Community Health Centers, Inc.
Subdivision Name
Care Resource
Type
Sexually Transmitted Diseases
340B ID
STD333113
Entity Address
871 W Oakland Park Blvd.
Wilton Manors, FL 33311
Grant Number
NU62PS924532
Participating Start Date
1/1/2024
Last Recertification Date
Entity Termination Date
7/1/2024
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
11/17/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Keri Kratofil, Chief Executive Officer
(305) 576-1234 Ext: 157
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/16/2023
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