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CYSTIC FIBROSIS SERVICES, LLC
STD85028 RSG Healthcare
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Covered Entity Details
Entity Name
RSG Healthcare
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD85028
Entity Address
11209 N Tatum BLVD
STE 185
Phoenix, AZ 85028
Grant Number
NU62PS924550
Participating Start Date
7/1/2024
Last Recertification Date
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
7/4/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Randy S Gelow, Owner/Medical Doctor
(602) 669-2585
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/4/2024
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