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CYSTIC FIBROSIS SERVICES, LLC
CHC00630-00 EASTPORT HEALTH CARE INC
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Covered Entity Details
Entity Name
EASTPORT HEALTH CARE INC
Subdivision Name
EASTPORT HEALTH CARE, INC.
Type
HRSA-Funded Health Center
340B ID
CHC00630-00
Entity Address
30 Boynton St
Eastport, ME 04631-1306
Grant Number
H80CS00630
Participating Start Date
7/1/2015
Last Recertification Date
2/11/2025
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
4/3/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ellen M Krajewski, CEO
(207) 853-4045
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/3/2024
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