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VITAL RX, LLC
CH051050 CHICAGO FAMILY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
CHICAGO FAMILY HEALTH CENTER, INC.
Subdivision Name
CHICAGO FAMILY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH051050
Entity Address
9119 S Exchange Ave
Chicago, IL 60617-4225
Grant Number
H80CS00514
Participating Start Date
1/1/1998
Last Recertification Date
3/7/2025
Pharmacy Details
Pharmacy Name
VITAL RX, LLC
Pharmacy Address
3110 W BELMONT AVE STE 1W
CHICAGO, IL 60618
Pharmacy Comments
Contract Details
Approval Date
10/11/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Moldovan, Chief Financial Officer
(773) 364-2206
Contract Pharmacy Representative
Vital RX
Anup Doshi, President
(773) 862-1699
Signed By Date
10/11/2019
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