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CYSTIC FIBROSIS SERVICES
CHC26601-00 Full Circle Health, Inc.
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Covered Entity Details
Entity Name
Full Circle Health, Inc.
Subdivision Name
Full Circle Health - Meridian
Type
HRSA-Funded Health Center
340B ID
CHC26601-00
Entity Address
2275 S Eagle Rd STE 120
Meridian, ID 83642-2620
Grant Number
H80CS26601
Participating Start Date
4/1/2014
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
CYSTIC FIBROSIS SERVICES
Pharmacy Address
CYSTIC FIBROSIS SERVICES, INC
10530 JOHN W ELLIOTT DR, STE 200
FRISCO, TX 75033
Pharmacy Comments
Contract Details
Approval Date
4/13/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/9/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ted Epperly, President and CEO
(208) 954-8745
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/13/2015
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