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CYSTIC FIBROSIS SERVICES, LLC
CAH271336-00 Logan Health - Whitefish
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Covered Entity Details
Entity Name
Logan Health - Whitefish
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH271336-00
Entity Address
1600 HOSPITAL WAY
WHITEFISH, MT 59937-2990
Medicare Provider Number
271336
Participating Start Date
7/1/2011
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
6/29/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/31/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
David Richhart, Chief Financial Officer
(406) 863-9826
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
6/29/2017
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