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HIGHLAND PARK CVS, L.L.C.
CH053320 SIHF Healthcare
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Covered Entity Details
Entity Name
SIHF Healthcare
Subdivision Name
SIHF Healthcare
Type
HRSA-Funded Health Center
340B ID
CH053320
Entity Address
2041 Goose Lake Rd,
Sauget, IL 62206-2822
Grant Number
H80CS00195
Participating Start Date
7/1/2001
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06389
1022 W. MAIN ST.
SALEM, IL 62881
Pharmacy Comments
Contract Details
Approval Date
10/3/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Larry McCulley, President
(618) 332-0694 Ext: 155
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/3/2019
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