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CYSTIC FIBROSIS SERVICES, LLC
STD752151 Abounding Prosperity, Inc.
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Covered Entity Details
Entity Name
Abounding Prosperity, Inc.
Subdivision Name
HOPE Health Center
Type
Sexually Transmitted Diseases
340B ID
STD752151
Entity Address
Abounding Prosperity, Inc HOPE Health Center
1619 Martin Luther King Jr. Blvd
Dallas, TX 75215
Grant Number
NU62PS924529
Participating Start Date
10/1/2017
Last Recertification Date
5/7/2024
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
10/7/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/15/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John Moyle, Nurse Practitioner (only monitor 340b database on behalf of CEO Tamara Stephney))
(469) 213-9593
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/7/2017
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