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CYSTIC FIBROSIS SERVICES, LLC
CAH281308-00 HENDERSON HEALTH CARE SERVICES
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Covered Entity Details
Entity Name
HENDERSON HEALTH CARE SERVICES
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH281308-00
Entity Address
1621 FRONT ST.
HENDERSON, NE 68371
Medicare Provider Number
281308
Participating Start Date
10/1/2014
Last Recertification Date
8/19/2024
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
4/12/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/25/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Cheryl Brown, CEO
(402) 723-4512 Ext: 4014
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/12/2018
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