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CYSTIC FIBROSIS SERVICES, LLC
CH031000 TUG RIVER HEALTH ASSOCIATION, INC
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Covered Entity Details
Entity Name
TUG RIVER HEALTH ASSOCIATION, INC
Subdivision Name
TUG RIVER HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH031000
Entity Address
5883 Black Diamond Highway
GARY, WV 24836-0507
Grant Number
H80CS00701
Participating Start Date
10/1/2016
Last Recertification Date
2/10/2025
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
1/16/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tim Crofton, Executive Director
(304) 448-2101
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/16/2018
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