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CYSTIC FIBROSIS SERVICES, LLC
CH03410E Portsmouth Community Health Center, Inc.
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Covered Entity Details
Entity Name
Portsmouth Community Health Center, Inc.
Subdivision Name
Barbara L. Willis Wellness Center
Type
HRSA-Funded Health Center
340B ID
CH03410E
Entity Address
1541 High Street
Portsmouth, VA 23704
Grant Number
H80CS00729
Participating Start Date
1/24/2023
Last Recertification Date
2/17/2025
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
1/11/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Barbara Willis, CEO
(757) 393-6363
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/11/2024
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