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CYSTIC FIBROSIS SERVICES, LLC
DSH330199 METROPOLITAN HOSPITAL CENTER (NYCHHC)
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Covered Entity Details
Entity Name
METROPOLITAN HOSPITAL CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330199
Entity Address
1901 FIRST AVE.
NEW YORK, NY 10029
Medicare Provider Number
330199
Participating Start Date
7/1/1993
Last Recertification Date
9/3/2024
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
7/13/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/13/2017
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