340B Drug Pricing Program Database
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AMERICAN DRUG STORES LLC
RWI606162 Alliance Care 360
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Covered Entity Details
Entity Name
Alliance Care 360
Subdivision Name
Type
Ryan White Part A
340B ID
RWI606162
Entity Address
2929 S Wabash Avenue,
Suite
202
Chicago, IL 60616-3243
Grant Number
H89HA00008
Participating Start Date
7/1/2018
Last Recertification Date
2/3/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
AMERICAN DRUG STORES LLC
Pharmacy Address
DBA OSCO DRUG 4060
7910 S CICEREO AVE
BURBANK, IL 60459
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/10/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ariq Cabbler, Director
(312) 808-1044 Ext: 101
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
1/15/2020
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