340B Drug Pricing Program Database
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RRC140223-29 ADVOCATE LUTHERAN GENERAL HOSPITAL (Active)
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Main Details
Name
ADVOCATE LUTHERAN GENERAL HOSPITAL
Subdivision Name
Elgin Infusion - Hematology
Type
Rural Referral Center
Rural
Yes
340B ID
RRC140223-29
Medicare Provider Number
140223
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/7/2023
Participating Start Date
10/1/2023
Participating Approval Date
8/1/2023
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Advocate Aurora Health Care
Nan Nelson, SVP-Finance
(414) 378-4765
Primary Contact
Advocate Aurora Health
Jason G Nowak, Director, Pharmacy 340B Program
(414) 640-8457
Addresses
Street Address
1425 N Randall Rd
Elgin, IL 60123
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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