Contract Pharmacy Details

CYSTIC FIBROSIS SERVICES, LLC
CHC28966-01 KANSAS CITY CARE CLINIC

Covered Entity Details

Entity Name

KANSAS CITY CARE CLINIC

Subdivision Name

KC CARE Clinic - Broadway

Type

HRSA-Funded Health Center

340B ID

CHC28966-01

Entity Address

3515 BROADWAY BLVD
KANSAS CITY, MO 64111-2537

Grant Number

H80CS28966

Participating Start Date

1/1/2016

Last Recertification Date

3/5/2025

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

12/15/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Sheilahn Davis-Wyatt, Senior Vice President & COO
(816) 777-2765

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

6/28/2017

340B Drug Pricing Program Database