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PHARMCHEMETICS INC DBA LAWRENCE HOUSE PH
CH051900 Heartland Alliance Health
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Covered Entity Details
Entity Name
Heartland Alliance Health
Subdivision Name
Heartland Alliance Health - Uptown
Type
HRSA-Funded Health Center
340B ID
CH051900
Entity Address
4009 N Broadway St
Chicago, IL 60613-2110
Grant Number
H80CS00111
Participating Start Date
1/1/2001
Last Recertification Date
1/29/2024
Pharmacy Details
Pharmacy Name
PHARMCHEMETICS INC DBA LAWRENCE HOUSE PH
Pharmacy Address
1001 W LAWRENCE AVE
CHICAGO, IL 60640-5017
Pharmacy Comments
Contract Details
Approval Date
10/2/2018
Contract Begin Date
10/2/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ed Stellon, Executive Director
(773) 751-4109
Contract Pharmacy Representative
Lawrence House Pharmacy
JOSEPH ROGOWIN, OWNER - PRESIDENT
(773) 561-2288
Signed By Date
10/2/2018
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