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CYSTIC FIBROSIS SERVICES, LLC
CH01241K Staywell Health Care, Inc.
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Covered Entity Details
Entity Name
Staywell Health Care, Inc.
Subdivision Name
StayWell Health Center at Western CT Mental Health Network
Type
HRSA-Funded Health Center
340B ID
CH01241K
Entity Address
95 Thomaston Ave
Waterbury, CT 06702-1007
Grant Number
H80CS00350
Participating Start Date
1/1/2018
Last Recertification Date
2/12/2025
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
7/14/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Donald Thompson, CEO
(203) 756-8021 Ext: 3016
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/14/2024
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