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CYSTIC FIBROSIS SERVICES, LLC
CH05183Q COUNTY OF INGHAM
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Covered Entity Details
Entity Name
COUNTY OF INGHAM
Subdivision Name
East Lansing Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH05183Q
Entity Address
509 Burcham Dr
East Lansing, MI 48823-2750
Grant Number
H80CS00030
Participating Start Date
4/1/2024
Last Recertification Date
Entity Termination Date
1/1/2025
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
4/16/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kris Drake, Executive Director/Deputy Health Officer
(517) 887-4361
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/16/2024
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