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CYSTIC FIBROSIS SERVICES, LLC
DSH500026 SWEDISH EDMONDS
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Covered Entity Details
Entity Name
SWEDISH EDMONDS
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500026
Entity Address
21601 76TH AVENUE WEST
EDMONDS, WA 98026-7507
Medicare Provider Number
500026
Participating Start Date
1/1/2025
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
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/12/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Sheri Feeney, Chief Financial Officer
(206) 628-2530
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/17/2017
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