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CYSTIC FIBROSIS SERVICES, LLC
FQHCLA462A HASC DIAGNOSTIC AND TREATMENT CENTER, INC.
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Covered Entity Details
Entity Name
HASC DIAGNOSTIC AND TREATMENT CENTER, INC.
Subdivision Name
HASC Diagnostic and Treatment Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA462A
Entity Address
1122 Chestnut Ave
Brooklyn, NY 11230-5844
Grant Number
LALCS52978
Participating Start Date
4/1/2024
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
1/1/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tzvi Kahn, CEO
(718) 942-3860
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/1/2025
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