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UNITED RX LLC
STD60608 Alliance Care 360
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Covered Entity Details
Entity Name
Alliance Care 360
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD60608
Entity Address
2929 S Wabash Avenue,
Suite
202
Chicago, IL 60616-2327
Grant Number
1-NU62PS924733-01-00
Participating Start Date
8/30/2021
Last Recertification Date
5/8/2025
Pharmacy Details
Pharmacy Name
UNITED RX LLC
Pharmacy Address
150 FENCL LN
HILLSIDE, IL 60162
Pharmacy Comments
Contract Details
Approval Date
1/2/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Ariq Cabbler, Director
(312) 808-1044 Ext: 101
Contract Pharmacy Representative
United/XCel-Rx, LLC
Chuck Benain, Chief Operating Officer
(708) 449-7600 Ext: 373
Signed By Date
1/2/2020
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