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WAL-MART PHARMACY 10-0933
CH05006G COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS
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Covered Entity Details
Entity Name
COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS
Subdivision Name
COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS
Type
HRSA-Funded Health Center
340B ID
CH05006G
Entity Address
202 NORTH SCHUYLER AVE STE 206
Kankakee, IL 60901-3833
Grant Number
H80CS00748
Participating Start Date
4/6/2020
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0933
Pharmacy Address
311 E ROUTE 38
ROCHELLE, IL 61068
Pharmacy Comments
Contract Details
Approval Date
10/13/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eleace Erica Sawyers, Chief Executive Officer
(786) 299-1724
Contract Pharmacy Representative
Wal Mart
Julie Howard, 340b Pharmacy Manager
(479) 739-1973
Signed By Date
10/13/2020
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