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CYSTIC FIBROSIS SERVICES, LLC
STD97214 Cascade AIDS Project
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Covered Entity Details
Entity Name
Cascade AIDS Project
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD97214
Entity Address
2236 SE Belmont Street
Portland, OR 97214
Grant Number
NU62PS924543
Participating Start Date
7/1/2017
Last Recertification Date
5/6/2024
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
1/19/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tyler A. TerMeer, Executive Director
(503) 278-3810
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/19/2018
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