Pharmacy Details

WAL-MART PHARMACY 10-3065 - information as of 6/8/2025 1:41:39 AM

Name
WAL-MART PHARMACY 10-3065

Address

3636 N BROADWAY
CHICAGO, IL 60613

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	DSH140080	PRESENCE SAINT FRANCIS HOSPITAL		Disproportionate Share Hospital	355 RIDGE AVE.		EVANSTON	IL	09/14/2012	07/01/2015	9/23/2015 6:09 PM
Details	DSH140182	ADVOCATE NORTH SIDE HEALTH NETWORK	DBA ADVOCATE ILLINOIS MASONIC MEDICAL CENTER (AIMMC)	Disproportionate Share Hospital	836 West Wellington Ave.		CHICAGO	IL	01/01/2016	02/14/2016	3/21/2016 5:48 PM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Comments	Update				3/28/2013 4:21 PM
Addresses	Pharmacy Address	Update		Wal-Mart 3636 N BROADWAY ST CHICAGO, IL 60613	WAL-MART PHARMACY 10-3065 3636 N BROADWAY CHICAGO, IL 60613	9/14/2012 1:46 PM
Details	Name	Update		Wal-Mart	WAL-MART PHARMACY 10-3065	9/14/2012 1:46 PM
Details	Comments	Insert				8/24/2012 8:14 AM
Details	Is Deleted	Insert			False	8/24/2012 8:14 AM
Addresses	Pharmacy Address	Insert			Wal-Mart 3636 N BROADWAY ST CHICAGO, IL 60613	8/24/2012 8:14 AM
Details	Name	Insert			Wal-Mart	8/24/2012 8:14 AM