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VICTORY RX INC
CH05930B FAMILY CHRISTIAN HEALTH CENTER
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Covered Entity Details
Entity Name
FAMILY CHRISTIAN HEALTH CENTER
Subdivision Name
Family Christian Health Center Lynwood
Type
HRSA-Funded Health Center
340B ID
CH05930B
Entity Address
19767 Torrence Ave
Lynwood, IL 60411
Grant Number
H80CS00879
Participating Start Date
7/1/2017
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
VICTORY RX INC
Pharmacy Address
DBA LOCAL HEALTH PHARMACY
2545 W DIVERSEY AVE STE 104
CHICAGO, IL 60647-7173
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/22/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lisa Green, CEO
(708) 339-5525
Contract Pharmacy Representative
J&M Pharmacy
Adonis Ducre, Pharmacy Owner
(773) 285-6290
Signed By Date
10/15/2019
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