Contract Pharmacy Details

HIGHLAND PARK CVS, L.L.C.
CHC29004-00 HOWARD BROWN HEALTH CENTER

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 # 04061
520 S. STATE STREET
CHICAGO, IL 60605

Pharmacy Comments

Contract Details

Approval Date

7/15/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Anthony Scott Armstrong, Vice President of Strategy and Business Development
(407) 765-5579

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/15/2020

340B Drug Pricing Program Database