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AMBER ENTERPRISES, INC
DSH140119 RUSH UNIVERSITY MEDICAL CENTER
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Covered Entity Details
Entity Name
RUSH UNIVERSITY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140119
Entity Address
1653 W CONGRESS PKWY
CHICAGO, IL 60612
Medicare Provider Number
140119
Participating Start Date
12/1/2005
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
AMBER ENTERPRISES, INC
Pharmacy Address
DBA AMBER SPECIALTY PHARMACY
1 E ERIE ST STE 630
CHICAGO, IL 60611
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John Mordach, Chief Financial Officer
(312) 942-5600
Contract Pharmacy Representative
Amber Pharmacy
Shauna Santare, Pharmacy Manager
(888) 370-1724 Ext: 1404
Signed By Date
1/15/2019
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