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RECEPT PHARMACY LP
RWI60614 Chicago House and Social Service Agency
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Covered Entity Details
Entity Name
Chicago House and Social Service Agency
Subdivision Name
Type
Ryan White Part A
340B ID
RWI60614
Entity Address
2229 S Michigan Avenue
Suite 304
Chicago, IL 60616
Grant Number
H89HA00008
Participating Start Date
10/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RECEPT PHARMACY LP
Pharmacy Address
DBA RECEPT PHARMACY #125
5501 S HALSTED ST STE 147
CHICAGO, IL 60621-2229
Pharmacy Comments
Contract Details
Approval Date
1/11/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott Ammarell, Chief Executive Officer
(773) 248-5200 Ext: 202
Contract Pharmacy Representative
ReceptRX
Clay Keene, Vice President, Client Services
(914) 705-9046
Signed By Date
1/11/2019
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