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ELSDON MEDICAL 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
ELSDON MEDICAL PHARMACY
Pharmacy Address
7456 S STATE RD STE 101
BEDFORD PARK, IL 60638
Pharmacy Comments
Contract Details
Approval Date
10/9/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/2/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kristin Keglovitz-Baker, SVP, Chief Operating Officer
(773) 388-8901
Contract Pharmacy Representative
Elsdon Pharmacy
MAJED ABDALLAH, PRESIDENT
(708) 220-7640
Signed By Date
10/9/2019
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