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CYSTIC FIBROSIS SERVICES, LLC
DSH330193 FLUSHING HOSPITAL MEDICAL CENTER
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Covered Entity Details
Entity Name
FLUSHING HOSPITAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330193
Entity Address
4500 PARSONS BLVD
PARSONS BLVD AND 45TH AVENUE
FLUSHING, NY 11355
Medicare Provider Number
330193
Participating Start Date
10/1/2004
Last Recertification Date
8/14/2024
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
7/7/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MOUNIR F. DOSS, EXECUTIVE VP & CFO
(718) 206-6291
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/7/2017
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