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HIGHLAND PARK CVS, L.L.C.
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
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03742
121 W KINZIE ST
CHICAGO, IL 60654
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kristin Keglovitz-Baker, SVP, Chief Operating Officer
(773) 388-8901
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2020
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