Contract Pharmacy Details

CYSTIC FIBROSIS SERVICES, LLC
RWI94612A AIDS PROJECT OF THE EAST BAY

Covered Entity Details

Entity Name

AIDS PROJECT OF THE EAST BAY

Subdivision Name

Type

Ryan White Part A

340B ID

RWI94612A

Entity Address

8400 Enterprise Way
APEB, Suite 120
Oakland, CA 94612

Grant Number

H89HA00018

Participating Start Date

4/1/2017

Last Recertification Date

2/20/2018

Entity Termination Date

4/1/2019

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

1/5/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Robert Newells, Executive Director
(510) 663-7950 Ext: 150

Contract Pharmacy Representative

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

Signed By Date

1/5/2018

340B Drug Pricing Program Database