340B Drug Pricing Program Database
AMERICAN DRUG STORES LLC
DSH140119 RUSH UNIVERSITY MEDICAL CENTER - information as of 5/6/2025 12:47:23 AM
Covered Entity Details
Entity Name
RUSH UNIVERSITY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140119
Entity Address
1653 W CONGRESS PKWY
CHICAGO, IL 60612
Medicare Provider Number
140119
Participating Start Date
12/1/2005
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
AMERICAN DRUG STORES LLC
Pharmacy Address
DBA OSCO DRUG 1256
107 SOUTH RANDALL ROAD
ALGONQUIN, IL 60102
Pharmacy Comments
Contract Details
Approval Date
4/16/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/25/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John Mordach, Chief Financial Officer
(312) 942-5600
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
4/16/2018
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