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BIENESTAR PHARMACY
CHC29004-00 HOWARD BROWN HEALTH CENTER
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Covered Entity Details
Entity Name
HOWARD BROWN HEALTH CENTER
Subdivision Name
Howard Brown Health Center-Clark
Type
HRSA-Funded Health Center
340B ID
CHC29004-00
Entity Address
6500 N Clark St
Chicago, IL 60626-4002
Grant Number
H80CS29004
Participating Start Date
4/1/2016
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
BIENESTAR PHARMACY
Pharmacy Address
BIENESTAR PHARMACY
966 W. 21ST ST
STE 104
CHICAGO, IL 60608
Pharmacy Comments
Contract Details
Approval Date
7/13/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kristin Keglovitz-Baker, SVP, Chief Operating Officer
(773) 388-8901
Contract Pharmacy Representative
Bienestar Pharmacy
Snejal Bhavsar, Senior Associate
(630) 452-3938
Signed By Date
7/13/2019
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