Pharmacy Details

HIGHLAND PARK CVS, L.L.C. - information as of 4/25/2025 5:48:11 PM

Name
HIGHLAND PARK CVS, L.L.C.

Address

DBA: CVS/PHARMACY # 06389
1022 W. MAIN ST.
SALEM, IL 62881

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	CAH141345-00	Salem Township Hospital		Critical Access Hospital	1201 Ricker Drive		Salem	IL	01/01/2020		1/1/2020 12:05 AM
Details	CH053320	SIHF Healthcare	SIHF Healthcare	HRSA-Funded Health Center	2041 Goose Lake Rd,		Sauget	IL	01/01/2020		1/1/2020 12:05 AM
Details	DSH140046	SSM HEALTH GOOD SAMARITAN HOSPITAL		Disproportionate Share Hospital	1 GOOD SAMARITAN WAY		MT. VERNON	IL	07/01/2023		7/1/2023 12:01 AM
Details	RRC140034-00	ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS		Rural Referral Center	400 NORTH PLEASANT AVENUE		CENTRALIA	IL	07/01/2016	07/01/2023	7/1/2023 12:01 AM
Details	RRC140046-00	GOOD SAMARITAN REGIONAL HEALTH CTR.		Rural Referral Center	1 GOOD SAMARITAN WAY		MT. VERNON	IL	07/01/2021	07/01/2023	7/1/2023 12:01 AM
Details	RRC140046-00	GOOD SAMARITAN REGIONAL HEALTH CTR.		Rural Referral Center	1 GOOD SAMARITAN WAY		MT. VERNON	IL	07/01/2025		4/14/2025 10:11 AM

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 # 06389 1022 W. MAIN ST. SALEM, IL 62881	3/28/2013 4:21 PM
Details	Name	Insert			HIGHLAND PARK CVS, L.L.C.	3/28/2013 4:21 PM