340B Drug Pricing Program Database
HIGHLAND PARK CVS, L.L.C.
RRC140223-00 ADVOCATE LUTHERAN GENERAL HOSPITAL - information as of 4/24/2025 1:02:00 AM
Covered Entity Details
Entity Name
ADVOCATE LUTHERAN GENERAL HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC140223-00
Entity Address
1775 W. DEMPSTER STREET
PARK RIDGE, IL 60068
Medicare Provider Number
140223
Participating Start Date
4/1/2019
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03170
6417 W. HIGGINS AVE.
CHICAGO, IL 60656
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nan Nelson, SVP-Finance
(414) 378-4765
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session