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CYSTIC FIBROSIS SERVICES, LLC
CH033130 E.A. HAWSE HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
E.A. HAWSE HEALTH CENTER, INC.
Subdivision Name
Central Office
Type
HRSA-Funded Health Center
340B ID
CH033130
Entity Address
17978 STATE ROUTE 55
BAKER, WV 26801-0097
Grant Number
H80CS00563
Participating Start Date
10/1/2004
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
4/16/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GARY T. JOHNSON, CEO
(304) 897-5915 Ext: 230
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/16/2018
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