Pharmacy Details

HIGHLAND PARK CVS, L.L.C. - information as of 6/12/2025 9:54:04 PM

Name
HIGHLAND PARK CVS, L.L.C.

Address

DBA: CVS/PHARMACY # 06370
2700 BROADWAY
MOUNT VERNON, IL 62864

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	CAH141321-00	Franklin Hospital District		Critical Access Hospital	201 Bailey Lane		Benton	IL	07/01/2020		7/1/2020 12:01 AM
Details	CAH141324-00	Ferrell Hospital Community Foundation dba Ferrell Hospital		Critical Access Hospital	1201 Pine Street		Eldorado	IL	05/13/2020		5/13/2020 5:01 PM
Details	CAH141326-00	Hamilton Memorial Hospital District		Critical Access Hospital	611. S. Marshall Avenue		McLeansboro	IL	04/01/2021		4/1/2021 12:01 AM
Details	CAH141345-00	Salem Township Hospital		Critical Access Hospital	1201 Ricker Drive		Salem	IL	01/01/2021		1/1/2021 12:01 AM
Details	CH050040	SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION	SHAWNEE HEALTH SERVICE AND DEVELOPMENT C	HRSA-Funded Health Center	109 California St		Carterville	IL	04/01/2022		4/1/2022 12:01 AM
Details	CH052130	CHRISTOPHER RURAL HEALTH PLANNING CORP.	REA CLINIC	HRSA-Funded Health Center	4241 HWY 14 WEST		CHRISTOPHER	IL	01/01/2019		1/1/2019 12:05 AM
Details	CH053320	SIHF Healthcare	SIHF Healthcare	HRSA-Funded Health Center	2041 Goose Lake Rd,		Sauget	IL	01/01/2021		1/1/2021 12:01 AM
Details	DSH140046	SSM HEALTH GOOD SAMARITAN HOSPITAL		Disproportionate Share Hospital	1 GOOD SAMARITAN WAY		MT. VERNON	IL	07/01/2023	07/01/2025	5/5/2025 12:40 PM
Details	DSH260105	SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL		Disproportionate Share Hospital	1201 South Grand Blvd.		ST. LOUIS	MO	07/01/2021		7/1/2021 12:01 AM
Details	RRC140046-00	SSM HEALTH GOOD SAMARITAN HOSPITAL		Rural Referral Center	1 GOOD SAMARITAN WAY		MT. VERNON	IL	07/01/2016	07/01/2023	7/1/2023 12:01 AM
Details	RRC140046-00	SSM HEALTH GOOD SAMARITAN HOSPITAL		Rural Referral Center	1 GOOD SAMARITAN WAY		MT. VERNON	IL	07/01/2025		5/5/2025 12:40 PM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Comments	Insert				3/28/2013 4:21 PM
Details	Is Deleted	Insert			False	3/28/2013 4:21 PM
Addresses	Pharmacy Address	Insert			HIGHLAND PARK CVS, L.L.C. DBA: CVS/PHARMACY # 06370 2700 BROADWAY MOUNT VERNON, IL 62864	3/28/2013 4:21 PM
Details	Name	Insert			HIGHLAND PARK CVS, L.L.C.	3/28/2013 4:21 PM