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CYSTIC FIBROSIS SERVICES, LLC
DSH330115 ONEIDA HEALTHCARE CENTER
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Covered Entity Details
Entity Name
ONEIDA HEALTHCARE CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330115
Entity Address
321 GENESEE STREET
ONEIDA, NY 13421
Medicare Provider Number
330115
Participating Start Date
1/1/2015
Last Recertification Date
8/23/2024
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
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/12/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Gene Morreale, CEO
(315) 361-2300
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/12/2018
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