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OMAR PHARMACY INC
CH0512780 Tapestry 360 Health
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Covered Entity Details
Entity Name
Tapestry 360 Health
Subdivision Name
Tapestry 360 Health - Administration
Type
HRSA-Funded Health Center
340B ID
CH0512780
Entity Address
1301 W Devon Ave
Chicago, IL 60660
Grant Number
H80CS00215
Participating Start Date
1/1/2004
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OMAR PHARMACY INC
Pharmacy Address
DBA DRUG CENTER PHARMACY 101
845 W WILSON AVE
CHICAGO, IL 60640-8090
Pharmacy Comments
Contract Details
Approval Date
4/13/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/31/2023
Ownership change
Contacts
Covered Entity Signing Official
Gwenn Rausch, CEO
(773) 296-7587
Contract Pharmacy Representative
Omar Pharmacy Inc
Hani Abdallah, Manager
(708) 423-4700
Signed By Date
4/13/2019
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