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CYSTIC FIBROSIS SERVICES, LLC
CH034190 MINNIE HAMILTON HEALTH CARE CENTER
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Covered Entity Details
Entity Name
MINNIE HAMILTON HEALTH CARE CENTER
Subdivision Name
MINNIE HAMILTON HEALTH CARE CENTER
Type
HRSA-Funded Health Center
340B ID
CH034190
Entity Address
186 Hospital Dr
Grantsville, WV 26147-7100
Grant Number
H80CS00761
Participating Start Date
1/1/2004
Last Recertification Date
2/11/2025
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
4/5/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen Whited, CEO
(304) 354-9244 Ext: 5183
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/5/2018
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