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WALMART PHARMACY 10-5965
CH051050 CHICAGO FAMILY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
CHICAGO FAMILY HEALTH CENTER, INC.
Subdivision Name
CHICAGO FAMILY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH051050
Entity Address
9119 S Exchange Ave
Chicago, IL 60617-4225
Grant Number
H80CS00514
Participating Start Date
1/1/1998
Last Recertification Date
3/7/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5965
Pharmacy Address
10900 S. DOTY AVE.
CHICAGO, IL 60628
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Zakeya Atia, CFO
(773) 364-2223
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/15/2019
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