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CYSTIC FIBROSIS SERVICES, LLC
RWI28078 ROSEDALE HEALTH AND WELLNESS
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Covered Entity Details
Entity Name
ROSEDALE HEALTH AND WELLNESS
Subdivision Name
Type
Ryan White Part A
340B ID
RWI28078
Entity Address
103 COMMERCE CENTRE DRIVE
SUITE 103
HUNTERSVILLE, NC 28078
Grant Number
H89HA11434
Participating Start Date
7/1/2024
Last Recertification Date
2/10/2025
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
6/28/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Frederick A. Cruickshank, Medical Director
(704) 659-7276
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
6/28/2017
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