Contract Pharmacy Details

BOND DRUG COMPANY OF ILLINOIS, L.L.C.
CH05190B Heartland Alliance Health, Inc.

Covered Entity Details

Entity Name

Heartland Alliance Health, Inc.

Subdivision Name

HEARTLAND ALLIANCE HEALTH - ENGLEWOOD

Type

HRSA-Funded Health Center

340B ID

CH05190B

Entity Address

5501 S HALSTED ST
CHICAGO, IL 60621-2229

Grant Number

H80CS00111

Participating Start Date

7/1/2018

Last Recertification Date

1/29/2024

Pharmacy Details

Pharmacy Name

BOND DRUG COMPANY OF ILLINOIS, L.L.C.

Pharmacy Address

DBA: WALGREENS # 04542
5625 N. RIDGE AVE
CHICAGO, IL 60660-3434

Pharmacy Comments

Contract Details

Approval Date

4/2/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Ed Stellon, Executive Director
(773) 751-4109

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/2/2019

340B Drug Pricing Program Database