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PHARMCHEMETICS INC DBA LAWRENCE HOUSE PH
CH05190A Heartland Alliance Health, INC.
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Covered Entity Details
Entity Name
Heartland Alliance Health, INC.
Subdivision Name
Heartland Alliance Health James West Clinic
Type
HRSA-Funded Health Center
340B ID
CH05190A
Entity Address
932 W WASHINGTON BLVD
STE 224
Chicago, IL 60607-2217
Grant Number
H80CS00111
Participating Start Date
4/1/2014
Last Recertification Date
1/29/2024
Entity Termination Date
1/1/2025
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
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
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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