Covered Entity Details

CH059300 FAMILY CHRISTIAN HEALTH CENTER (Active) - information as of 6/23/2025 12:26:56 AM

Main Details

Name

FAMILY CHRISTIAN HEALTH CENTER

Subdivision Name

FAMILY CHRISTIAN HEALTH CENTER

Type

HRSA-Funded Health Center

Site ID

BPS-H80-005375

340B ID

CH059300

Grant Number

H80CS00879

Additional Details

Current Program Status

Active

Registration Date

4/1/2004

Participating Start Date

4/1/2004

Participating Approval Date

3/10/2004

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

Family Christian Health Center
Lisa Green, CEO
(708) 339-5525

Primary Contact

Family Christian Health Center
Mia Webster Cross, Chief of Programs and Outreach Officer
(708) 339-5593

Addresses

Street Address

31 W 155th St
Harvey, IL 60426-3556

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
NEW SITE 04/01/2004. 5/23/2001 CORRECTED ENTITIES PHYSICAL ADDRESS BACK TO 15620 SOUTH WOOD STREET, ADDED NEW SHIP TO AND BILL TO ADDRESS.	05/24/2011

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	AMERICAN DRUG STORES LLC	DBA OSCO DRUG 3188	17705 HALSTED ST	HOMEWOOD	IL	60430	04/08/2019	07/01/2019	02/01/2024	02/05/2024
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 02558	14700 HALSTED ST	HARVEY	IL	60426	10/12/2015	01/01/2016	03/29/2021	04/10/2021
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03179	820 183RD ST	HOMEWOOD	IL	60430	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03651	20950 GOVERNORS HWY.	OLYMPIA FIELDS	IL	60461	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03928	18301 PULASKI AVE	HAZEL CREST	IL	60429	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04336	1401 WESTERN AVE.	CHICAGO HEIGHTS	IL	60411	10/12/2015	01/01/2016	04/19/2017	04/19/2017
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04532	15 S. ORCHARD DR.	PARK FOREST	IL	60466	10/12/2015	01/01/2016	02/29/2024	03/04/2024
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS #21247	15940 KEDZIE AVE	MARKHAM	IL	60428-4017	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04947	13501 CICERO AVE	CRESTWOOD	IL	60418-1934	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05086	3120 CHICAGO RD	SOUTH CHICAGO HEIGHTS	IL	60411	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05126	3564 RIDGE RD	LANSING	IL	60438	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05127	18133 TORRENCE AVE	LANSING	IL	60438	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05128	2601 E SAUK TRL	SAUK VILLAGE	IL	60411	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05193	3145 W 147TH ST	POSEN	IL	60469	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05355	650 DIXIE HWY	CHICAGO HEIGHTS	IL	60411	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 11109	4800 148TH STREET	MIDLOTHIAN	IL	60445-3117	10/12/2015	01/01/2016		10/12/2015
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05104	5525 159TH ST	OAK FOREST	IL	60452	10/08/2020	01/01/2021		01/01/2021
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05055	12290 S PULASKI RD	ALSIP	IL	60803	10/15/2021	01/01/2022		01/01/2022
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04148	7960 W. 159TH ST.	ORLAND PARK	IL	60462	10/15/2021	01/01/2022		01/01/2022
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04949	7209 W. LINCOLN HWY.	FRANKFORT	IL	60423	10/15/2021	01/01/2022		01/01/2022
Contract Detail	BRIDGEPORT PHARMACY	3201 S WALLACE		CHICAGO	IL	60616	10/15/2014	01/01/2015	09/25/2017	09/25/2017
Contract Detail	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	10/16/2023	01/01/2024		01/01/2024
Contract Detail	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	10/16/2023	01/01/2024		01/01/2024
Contract Detail	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	01/16/2022	04/01/2022		04/01/2022
Contract Detail	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 00070	3200 FLOSSMOOR RD.	FLOSSMOOR	IL	60422	10/16/2023	01/01/2024		01/01/2024
Contract Detail	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 01768	3400 LINCOLN HWY.	OLYMPIA FIELDS	IL	60461	10/16/2023	01/01/2024		01/01/2024
Contract Detail	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 02935	8712 SOUTH STONY ISLAND AVE.	CHICAGO	IL	60617	10/16/2023	01/01/2024		01/01/2024
Contract Detail	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 03603	16701 S. HARLEM AVE.	TINLEY PARK	IL	60477	10/16/2023	01/01/2024		01/01/2024
Contract Detail	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 04978	14701 S. PULASKI RD.	MIDLOTHIAN	IL	60445	10/16/2023	01/01/2024		01/01/2024
Contract Detail	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 05769	470 S. TORRENCE AVE.	CALUMET CITY	IL	60409	10/16/2023	01/01/2024		01/01/2024
Contract Detail	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 07166	250 W. 144TH ST.	RIVERDALE	IL	60827	10/16/2023	01/01/2024		01/01/2024
Contract Detail	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 08512	1 MAIN STREET	PARK FOREST	IL	60466	10/16/2023	01/01/2024		01/01/2024
Contract Detail	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY #10537	1277 DIXIE HWY.	BEECHER	IL	60401	10/16/2023	01/01/2024		01/01/2024
Contract Detail	HIGHLAND PARK CVS, L.L.C.	CVS PHARMACY # 16792	17605 S HALSTED ST	HOMEWOOD	IL	60430	10/16/2023	01/01/2024		01/01/2024
Contract Detail	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 02520	6445 CALUMET AVE.	HAMMOND	IN	46324	10/16/2023	01/01/2024		01/01/2024
Contract Detail	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 02665	2272 NORTH MAIN ST.	CROWNPOINT	IN	46307	10/16/2023	01/01/2024		01/01/2024
Contract Detail	ICARE RX LLC	14447 COUNTRY WALK DR		MIAMI	FL	33186	07/16/2019	10/01/2019	09/13/2019	09/19/2019
Contract Detail	J AND M PHARMACY INC	LOCAL HEALTH PHARMACY - HARVEY	31 W 155TH ST SUITE 1000	HARVEY	IL	60426	10/15/2019	01/01/2020		01/01/2020
Contract Detail	LOCAL HEALTH, LLC	DBA LOCAL HEALTH PHARMACY - BEVERLY	2215 W 95TH ST	CHICAGO	IL	60643	10/15/2019	01/01/2020	06/22/2020	07/01/2020
Contract Detail	PHYSICIAN'S RX PHARMACY, LLC	PHYSICIANS RX PHARMACY, LLC	9701 APOLLO DRIVE #400	LARGO	MD	20774	07/16/2019	10/01/2019	09/13/2019	09/19/2019
Contract Detail	PHYSICIANS RX PHARMACY OF CLINTON, INC.	PHYSICIANS RX PHARMACY CLINTON	9131 PISCATAWAY ROAD SUITE 670	CLINTON	MD	20735	07/16/2019	10/01/2019	09/13/2019	09/19/2019
Contract Detail	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	01/16/2022	04/01/2022	10/01/2022	10/13/2023
Contract Detail	PRXP OF CA LLC	PRXP OF CA LLC	4345 E LOWELL ST STE C & D	ONTARIO	CA	91761	07/16/2019	10/01/2019	09/13/2019	09/19/2019
Contract Detail	PRXP OF KS LLC	PRXP OF KS LLC	300-340 SOUTHWEST BLVD SUITE 103	KANSAS CITY	KS	66103	07/16/2019	10/01/2019	09/13/2019	09/19/2019
Contract Detail	PRXP OF NEW YORK LLC	DBA BROADWAY FAMILY PHARMACY	601 AMSTERDAM AVE	NEW YORK	NY	10024	07/16/2019	10/01/2019	09/13/2019	09/19/2019
Contract Detail	SHIVAADI CORPORATION	3303 S HALSTED ST		CHICAGO	IL	60608-6877	04/14/2015	07/01/2015	01/15/2018	01/30/2018
Contract Detail	SURECARE DISCOUNT PHARMACY INC	DBA:SURECARE PHARMACY IL	4700 S CALIFORNIA AVE	CHICAGO	IL	60632	01/11/2018	01/11/2018	08/23/2019	09/19/2019
Contract Detail	SURECARE PHARMACY INC.	2001 S CALIFORNIA AVE	SUITE 103	CHICAGO	IL	60608-2486	10/13/2017	01/01/2018	01/01/2018	01/30/2018
Contract Detail	VICTORY RX INC	DBA LOCAL HEALTH PHARMACY	2545 W DIVERSEY AVE STE 104	CHICAGO	IL	60647-7173	10/15/2019	01/01/2020	06/22/2020	07/01/2020
Contract Detail	VICTORY RX INC	DBA LOCAL HEALTH PHARMACY	2545 W DIVERSEY AVE STE 104	CHICAGO	IL	60647-7173	10/15/2021	01/01/2022		01/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06332	1150 E SIBLEY BLVD	DOLTON	IL	60419-2828	10/12/2015	01/01/2016		10/12/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06564	522 TORRENCE AVE	CALUMET CITY	IL	60409	10/12/2015	01/01/2016		10/12/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06762	11833 S WESTERN AVE	CHICAGO	IL	60643-4734	10/12/2015	01/01/2016		10/12/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09330	18300 GOVERNORS HWY	HOMEWOOD	IL	60430-2910	10/12/2015	01/01/2016		10/12/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09357	833 W 115TH ST	CHICAGO	IL	60643-4619	10/12/2015	01/01/2016	11/09/2023	11/09/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09924	390 EAST 162ND STREET	SOUTH HOLLAND	IL	60473-0241	10/12/2015	01/01/2016		10/12/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS #10485	12854 S ASHLAND AVE	CALUMET PARK	IL	60827-6308	10/12/2015	01/01/2016		10/12/2015
Contract Detail	WALGREEN CO.	WALGREENS SPECIALTY PHARMACY #16498	2351 E 71ST ST SUITE A	CHICAGO	IL	60649	01/15/2020	04/01/2020		04/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04462	6510 COLUMBIA AVE.	HAMMOND	IN	46320	10/15/2021	01/01/2022		01/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09141	8700 S KEDZIE AVE	EVERGREEN PARK	IL	60805-1024	10/15/2021	01/01/2022		01/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06106	770 JOLIET ST	DYER	IN	46311	10/15/2021	01/01/2022		01/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09290	2500 GRANT ST	GARY	IN	46404-3508	10/15/2021	01/01/2022		01/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07411	3200 VOLLMER ROAD	OLYMPIA FIELDS	IL	60461-1122	10/15/2021	01/01/2022		01/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 00232	3405 S KING DR	CHICAGO	IL	60616	10/15/2021	01/01/2022	02/26/2025	02/26/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03352	6905 KENNEDY AVE	HAMMOND	IN	46323	10/15/2021	01/01/2022		01/01/2022
Contract Detail	Walgreens Central Fill #21399	4132Plainfield Rd	Ste 110	Indianapolis	IN	46231-7021	07/13/2023	10/01/2023		10/01/2023
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	01/16/2022	04/01/2022		04/01/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	01/16/2022	04/01/2022		04/01/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	01/16/2022	04/01/2022		04/01/2022

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH059300	Active	BPS-H80-005375	FAMILY CHRISTIAN HEALTH CENTER	FAMILY CHRISTIAN HEALTH CENTER	31 W 155th St	Harvey	IL
CH05930A	Active	BPS-H80-010918	FAMILY CHRISTIAN HEALTH CENTER	Family Christian Health Center	713 E. 142nd St.	Dolton	IL
CH05930B	Active	BPS-H80-018464	FAMILY CHRISTIAN HEALTH CENTER	Family Christian Health Center Lynwood	19767 Torrence Ave	Lynwood	IL
CH05930C	Active	BPS-H80-031495	Family Christian Health Center	Family Christian Health Center MCHC	15620 Wood St	Harvey	IL
CH05930D	Active	BPS-H80-033939	Family Christian Health Center	Family Christian Health Center Community Connect	31 E 155th St	Harvey	IL

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH05930A	AMERICAN DRUG STORES LLC	DBA OSCO DRUG 3188	17705 HALSTED ST	HOMEWOOD	IL	60430	07/01/2019	11/03/2023
CH05930B	AMERICAN DRUG STORES LLC	DBA OSCO DRUG 3188	17705 HALSTED ST	HOMEWOOD	IL	60430	07/01/2019	02/01/2024
CH059300	AMERICAN DRUG STORES LLC	DBA OSCO DRUG 3188	17705 HALSTED ST	HOMEWOOD	IL	60430	07/01/2019	02/01/2024
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 02558	14700 HALSTED ST	HARVEY	IL	60426	01/01/2016	03/29/2021
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03179	820 183RD ST	HOMEWOOD	IL	60430	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03651	20950 GOVERNORS HWY.	OLYMPIA FIELDS	IL	60461	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03928	18301 PULASKI AVE	HAZEL CREST	IL	60429	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04336	1401 WESTERN AVE.	CHICAGO HEIGHTS	IL	60411	01/01/2016	04/19/2017
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04532	15 S. ORCHARD DR.	PARK FOREST	IL	60466	01/01/2016	02/29/2024
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS #21247	15940 KEDZIE AVE	MARKHAM	IL	60428-4017	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04947	13501 CICERO AVE	CRESTWOOD	IL	60418-1934	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05086	3120 CHICAGO RD	SOUTH CHICAGO HEIGHTS	IL	60411	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05126	3564 RIDGE RD	LANSING	IL	60438	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05127	18133 TORRENCE AVE	LANSING	IL	60438	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05128	2601 E SAUK TRL	SAUK VILLAGE	IL	60411	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05193	3145 W 147TH ST	POSEN	IL	60469	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05355	650 DIXIE HWY	CHICAGO HEIGHTS	IL	60411	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 11109	4800 148TH STREET	MIDLOTHIAN	IL	60445-3117	01/01/2016
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05104	5525 159TH ST	OAK FOREST	IL	60452	01/01/2021
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05055	12290 S PULASKI RD	ALSIP	IL	60803	01/01/2022
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04148	7960 W. 159TH ST.	ORLAND PARK	IL	60462	01/01/2022
CH059300	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04949	7209 W. LINCOLN HWY.	FRANKFORT	IL	60423	01/01/2022
CH05930B	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05126	3564 RIDGE RD	LANSING	IL	60438	07/01/2024
CH059300	BRIDGEPORT PHARMACY	3201 S WALLACE		CHICAGO	IL	60616	01/01/2015	09/25/2017
CH059300	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2024
CH059300	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2024
CH059300	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	04/01/2022
CH059300	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 00070	3200 FLOSSMOOR RD.	FLOSSMOOR	IL	60422	01/01/2024
CH059300	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 01768	3400 LINCOLN HWY.	OLYMPIA FIELDS	IL	60461	01/01/2024
CH059300	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 02935	8712 SOUTH STONY ISLAND AVE.	CHICAGO	IL	60617	01/01/2024
CH059300	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 03603	16701 S. HARLEM AVE.	TINLEY PARK	IL	60477	01/01/2024
CH059300	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 04978	14701 S. PULASKI RD.	MIDLOTHIAN	IL	60445	01/01/2024
CH059300	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 05769	470 S. TORRENCE AVE.	CALUMET CITY	IL	60409	01/01/2024
CH059300	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 07166	250 W. 144TH ST.	RIVERDALE	IL	60827	01/01/2024
CH059300	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 08512	1 MAIN STREET	PARK FOREST	IL	60466	01/01/2024
CH059300	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY #10537	1277 DIXIE HWY.	BEECHER	IL	60401	01/01/2024
CH059300	HIGHLAND PARK CVS, L.L.C.	CVS PHARMACY # 16792	17605 S HALSTED ST	HOMEWOOD	IL	60430	01/01/2024
CH05930A	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 07166	250 W. 144TH ST.	RIVERDALE	IL	60827	07/01/2024
CH059300	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 02520	6445 CALUMET AVE.	HAMMOND	IN	46324	01/01/2024
CH059300	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 02665	2272 NORTH MAIN ST.	CROWNPOINT	IN	46307	01/01/2024
CH059300	ICARE RX LLC	14447 COUNTRY WALK DR		MIAMI	FL	33186	10/01/2019	09/13/2019
CH05930B	ICARE RX LLC	14447 COUNTRY WALK DR		MIAMI	FL	33186	10/01/2019	09/13/2019
CH05930A	ICARE RX LLC	14447 COUNTRY WALK DR		MIAMI	FL	33186	10/01/2019	09/13/2019
CH05930A	J AND M PHARMACY INC	LOCAL HEALTH PHARMACY - HARVEY	31 W 155TH ST SUITE 1000	HARVEY	IL	60426	01/01/2020	11/03/2023
CH05930B	J AND M PHARMACY INC	LOCAL HEALTH PHARMACY - HARVEY	31 W 155TH ST SUITE 1000	HARVEY	IL	60426	01/01/2020	02/01/2024
CH059300	J AND M PHARMACY INC	LOCAL HEALTH PHARMACY - HARVEY	31 W 155TH ST SUITE 1000	HARVEY	IL	60426	01/01/2020
CH05930C	J AND M PHARMACY INC	LOCAL HEALTH PHARMACY - HARVEY	31 W 155TH ST SUITE 1000	HARVEY	IL	60426	07/01/2024
CH05930B	LOCAL HEALTH, LLC	DBA LOCAL HEALTH PHARMACY - BEVERLY	2215 W 95TH ST	CHICAGO	IL	60643	01/01/2020	06/22/2020
CH059300	LOCAL HEALTH, LLC	DBA LOCAL HEALTH PHARMACY - BEVERLY	2215 W 95TH ST	CHICAGO	IL	60643	01/01/2020	06/22/2020
CH05930A	LOCAL HEALTH, LLC	DBA LOCAL HEALTH PHARMACY - BEVERLY	2215 W 95TH ST	CHICAGO	IL	60643	01/01/2020	06/22/2020
CH059300	PHYSICIAN'S RX PHARMACY, LLC	PHYSICIANS RX PHARMACY, LLC	9701 APOLLO DRIVE #400	LARGO	MD	20774	10/01/2019	09/13/2019
CH05930A	PHYSICIAN'S RX PHARMACY, LLC	PHYSICIANS RX PHARMACY, LLC	9701 APOLLO DRIVE #400	LARGO	MD	20774	10/01/2019	09/13/2019
CH05930B	PHYSICIAN'S RX PHARMACY, LLC	PHYSICIANS RX PHARMACY, LLC	9701 APOLLO DRIVE #400	LARGO	MD	20774	10/01/2019	09/13/2019
CH05930A	PHYSICIANS RX PHARMACY OF CLINTON, INC.	PHYSICIANS RX PHARMACY CLINTON	9131 PISCATAWAY ROAD SUITE 670	CLINTON	MD	20735	10/01/2019	09/13/2019
CH05930B	PHYSICIANS RX PHARMACY OF CLINTON, INC.	PHYSICIANS RX PHARMACY CLINTON	9131 PISCATAWAY ROAD SUITE 670	CLINTON	MD	20735	10/01/2019	09/13/2019
CH059300	PHYSICIANS RX PHARMACY OF CLINTON, INC.	PHYSICIANS RX PHARMACY CLINTON	9131 PISCATAWAY ROAD SUITE 670	CLINTON	MD	20735	10/01/2019	09/13/2019
CH059300	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	04/01/2022	10/01/2022
CH05930B	PRXP OF CA LLC	PRXP OF CA LLC	4345 E LOWELL ST STE C & D	ONTARIO	CA	91761	10/01/2019	09/13/2019
CH05930A	PRXP OF CA LLC	PRXP OF CA LLC	4345 E LOWELL ST STE C & D	ONTARIO	CA	91761	10/01/2019	09/13/2019
CH059300	PRXP OF CA LLC	PRXP OF CA LLC	4345 E LOWELL ST STE C & D	ONTARIO	CA	91761	10/01/2019	09/13/2019
CH05930A	PRXP OF KS LLC	PRXP OF KS LLC	300-340 SOUTHWEST BLVD SUITE 103	KANSAS CITY	KS	66103	10/01/2019	09/13/2019
CH059300	PRXP OF KS LLC	PRXP OF KS LLC	300-340 SOUTHWEST BLVD SUITE 103	KANSAS CITY	KS	66103	10/01/2019	09/13/2019
CH05930B	PRXP OF KS LLC	PRXP OF KS LLC	300-340 SOUTHWEST BLVD SUITE 103	KANSAS CITY	KS	66103	10/01/2019	09/13/2019
CH059300	PRXP OF NEW YORK LLC	DBA BROADWAY FAMILY PHARMACY	601 AMSTERDAM AVE	NEW YORK	NY	10024	10/01/2019	09/13/2019
CH05930A	PRXP OF NEW YORK LLC	DBA BROADWAY FAMILY PHARMACY	601 AMSTERDAM AVE	NEW YORK	NY	10024	10/01/2019	09/13/2019
CH05930B	PRXP OF NEW YORK LLC	DBA BROADWAY FAMILY PHARMACY	601 AMSTERDAM AVE	NEW YORK	NY	10024	10/01/2019	09/13/2019
CH059300	SHIVAADI CORPORATION	3303 S HALSTED ST		CHICAGO	IL	60608-6877	07/01/2015	01/15/2018
CH059300	SURECARE DISCOUNT PHARMACY INC	DBA:SURECARE PHARMACY IL	4700 S CALIFORNIA AVE	CHICAGO	IL	60632	01/11/2018	08/23/2019
CH059300	SURECARE PHARMACY INC.	2001 S CALIFORNIA AVE	SUITE 103	CHICAGO	IL	60608-2486	01/01/2018	01/01/2018
CH05930A	VICTORY RX INC	DBA LOCAL HEALTH PHARMACY	2545 W DIVERSEY AVE STE 104	CHICAGO	IL	60647-7173	01/01/2020	06/22/2020
CH05930B	VICTORY RX INC	DBA LOCAL HEALTH PHARMACY	2545 W DIVERSEY AVE STE 104	CHICAGO	IL	60647-7173	01/01/2020	06/22/2020
CH059300	VICTORY RX INC	DBA LOCAL HEALTH PHARMACY	2545 W DIVERSEY AVE STE 104	CHICAGO	IL	60647-7173	01/01/2020	06/22/2020
CH059300	VICTORY RX INC	DBA LOCAL HEALTH PHARMACY	2545 W DIVERSEY AVE STE 104	CHICAGO	IL	60647-7173	01/01/2022
CH059300	WALGREEN CO.	DBA: WALGREENS # 06332	1150 E SIBLEY BLVD	DOLTON	IL	60419-2828	01/01/2016
CH059300	WALGREEN CO.	DBA: WALGREENS # 06564	522 TORRENCE AVE	CALUMET CITY	IL	60409	01/01/2016
CH059300	WALGREEN CO.	DBA: WALGREENS # 06762	11833 S WESTERN AVE	CHICAGO	IL	60643-4734	01/01/2016
CH059300	WALGREEN CO.	DBA: WALGREENS # 09330	18300 GOVERNORS HWY	HOMEWOOD	IL	60430-2910	01/01/2016
CH059300	WALGREEN CO.	DBA: WALGREENS # 09357	833 W 115TH ST	CHICAGO	IL	60643-4619	01/01/2016	11/09/2023
CH059300	WALGREEN CO.	DBA: WALGREENS # 09924	390 EAST 162ND STREET	SOUTH HOLLAND	IL	60473-0241	01/01/2016
CH059300	WALGREEN CO.	DBA: WALGREENS #10485	12854 S ASHLAND AVE	CALUMET PARK	IL	60827-6308	01/01/2016
CH059300	WALGREEN CO.	WALGREENS SPECIALTY PHARMACY #16498	2351 E 71ST ST SUITE A	CHICAGO	IL	60649	04/01/2020
CH05930A	WALGREEN CO.	WALGREENS SPECIALTY PHARMACY #16498	2351 E 71ST ST SUITE A	CHICAGO	IL	60649	04/01/2020	11/03/2023
CH05930B	WALGREEN CO.	WALGREENS SPECIALTY PHARMACY #16498	2351 E 71ST ST SUITE A	CHICAGO	IL	60649	04/01/2020	02/01/2024
CH059300	WALGREEN CO.	DBA: WALGREENS # 04462	6510 COLUMBIA AVE.	HAMMOND	IN	46320	01/01/2022
CH059300	WALGREEN CO.	DBA: WALGREENS # 09141	8700 S KEDZIE AVE	EVERGREEN PARK	IL	60805-1024	01/01/2022
CH059300	WALGREEN CO.	DBA: WALGREENS # 06106	770 JOLIET ST	DYER	IN	46311	01/01/2022
CH059300	WALGREEN CO.	DBA: WALGREENS # 09290	2500 GRANT ST	GARY	IN	46404-3508	01/01/2022
CH059300	WALGREEN CO.	DBA: WALGREENS # 07411	3200 VOLLMER ROAD	OLYMPIA FIELDS	IL	60461-1122	01/01/2022
CH059300	WALGREEN CO.	DBA: WALGREENS # 00232	3405 S KING DR	CHICAGO	IL	60616	01/01/2022	02/26/2025
CH059300	WALGREEN CO.	DBA: WALGREENS # 03352	6905 KENNEDY AVE	HAMMOND	IN	46323	01/01/2022
CH059300	Walgreens Central Fill #21399	4132Plainfield Rd	Ste 110	Indianapolis	IN	46231-7021	10/01/2023
CH059300	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	04/01/2022
CH059300	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	04/01/2022
CH059300	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	04/01/2022

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/5/2024 4:58:04 PM	2/10/2025 6:38:22 PM	2/10/2025 6:38 PM
Details	Last Recertification Date	Update	Recertification	2/7/2023 3:00:37 PM	2/5/2024 4:58:04 PM	2/5/2024 4:58 PM
Details	Last Recertification Date	Update	Recertification	2/9/2022 2:28:38 PM	2/7/2023 3:00:37 PM	2/7/2023 3:00 PM
Contacts	Primary Contact	Update	Profile Change Request	Cross, Mia Webster Director of Community Health and Programs Family Christian Health Center 7083395593	Cross, Mia Webster Chief of Programs and Outreach Officer Family Christian Health Center 7083395593	2/6/2023 2:09 PM
Details	Last Recertification Date	Update	Recertification	2/9/2021 6:59:35 PM	2/9/2022 2:28:38 PM	2/9/2022 2:28 PM
Contacts	Primary Contact	Update	Profile Change Request	Cross, Mia Webster Director of Enabling Services and Programs Family Christian Health Center 7083395593	Cross, Mia Webster Director of Community Health and Programs Family Christian Health Center 7083395593	4/6/2021 7:25 PM
Details	Last Recertification Date	Update	Recertification	2/3/2020 1:35:15 PM	2/9/2021 6:59:35 PM	2/9/2021 6:59 PM
Contacts	Primary Contact	Update	Profile Change Request	Cross, MIa Webster Director of Enabling Services and Programs Family Christian Health Center 7083395593	Cross, Mia Webster Director of Enabling Services and Programs Family Christian Health Center 7083395593	6/23/2020 6:58 AM
Contacts	Primary Contact	Update	Profile Change Request	Cross, MIa Webster Director of Clinical Operations Family Christian Health Center 7083395593	Cross, MIa Webster Director of Enabling Services and Programs Family Christian Health Center 7083395593	6/22/2020 7:50 PM
Details	Last Recertification Date	Update	Recertification	2/22/2019 12:05:21 PM	2/3/2020 1:35:15 PM	2/3/2020 1:35 PM
Details	Last Recertification Date	Update	Recertification	2/20/2018 3:40:27 PM	2/22/2019 12:05:21 PM	2/22/2019 12:05 PM
Details	Last Recertification Date	Update	Recertification	2/20/2017 12:00:00 AM	2/20/2018 3:40:27 PM	2/20/2018 3:40 PM
Contacts	Authorizing Official	Update		Green, Lisa CEO 7083395525	Green, Lisa CEO Family Christian Health Center 7083395525	10/13/2017 1:27 PM
Contacts	Primary Contact	Update		Cross, MIa Webster Director of Clinical Operations 7083395593	Cross, MIa Webster Director of Clinical Operations Family Christian Health Center 7083395593	10/13/2017 12:01 PM
Contacts	Authorizing Official	Update		ROSE, TOM CEO 7083395525	Green, Lisa CEO 7083395525	5/1/2017 6:07 PM
Contacts	Primary Contact	Update		COLVIN, ANN CLINICAL NURSE MANAGER 7084660170	Cross, MIa Webster Director of Clinical Operations 7083395593	5/1/2017 6:07 PM
Addresses	Main Address	Insert			31 W 155th St Harvey, IL 60426-3556	2/20/2017 5:21 PM
Details	Last Recertification Date	Update		2/12/2016 12:00:00 AM	2/20/2017 12:00:00 AM	2/20/2017 5:21 PM
Details	Last Recertification Date	Update		3/9/2015 12:00:00 AM	2/12/2016 12:00:00 AM	2/12/2016 11:02 AM
Details	Last Recertification Date	Update		3/18/2014 12:00:00 AM	3/9/2015 12:00:00 AM	3/9/2015 10:20 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/18/2014 12:00:00 AM	3/18/2014 5:16 PM
Details	Entity Subname	Update			FAMILY CHRISTIAN HEALTH CENTER	3/18/2014 5:16 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	3/7/2013 8:12 AM
Contacts	Primary Contact	Insert			COLVIN, ANN CLINICAL NURSE MANAGER 7084660170	8/9/2011 1:31 PM
Contacts	Authorizing Official	Insert			ROSE, TOM CEO 7083395525	5/24/2011 9:40 AM
Details	Last Recertification Date	Insert				5/24/2011 9:40 AM
Details	Grant Number	Insert			H80CS00879	5/24/2011 9:40 AM
Details	340B ID	Insert			CH059300	5/24/2011 9:40 AM
Details	Is Authorizing Official EHB Data	Insert				5/24/2011 9:40 AM
Dates	Last Date That 340B Drugs Purchased	Insert				5/24/2011 9:40 AM
Details	Medicare Provider Number	Insert				5/24/2011 9:40 AM
Details	Entity Name	Insert			FAMILY CHRISTIAN HEALTH CENTER	5/24/2011 9:40 AM
Details	Program Code	Insert			CH	5/24/2011 9:40 AM
Details	Entity Subname	Insert				5/24/2011 9:40 AM
Dates	Participating Approval Date	Insert			3/10/2004 12:00:00 AM	5/24/2011 9:40 AM
Details	State	Insert			Active	5/24/2011 9:40 AM
Dates	Registration Date	Insert			4/1/2004 12:00:00 AM	5/24/2011 9:40 AM
Dates	Signed By Date	Insert				5/24/2011 9:40 AM
Dates	Start Date	Insert			4/1/2004 12:00:00 AM	5/24/2011 9:40 AM
Terminations	Termination Comments	Insert				5/24/2011 9:40 AM
Terminations	Termination Date	Insert				5/24/2011 9:40 AM
Terminations	Termination Effective Date	Insert				5/24/2011 9:40 AM
Terminations	Termination Reason	Insert				5/24/2011 9:40 AM
Details	Comments Public	Insert			NEW SITE 04/01/2004. 5/23/2001 CORRECTED ENTITIES PHYSICAL ADDRESS BACK TO 15620 SOUTH WOOD STREET, ADDED NEW SHIP TO AND BILL TO ADDRESS.	5/24/2011 9:40 AM

340B Drug Pricing Program Database