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HIGHLAND PARK CVS, L.L.C.
RWII61265A The Project of the Quad Cities
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Covered Entity Details
Entity Name
The Project of the Quad Cities
Subdivision Name
Type
Ryan White Part B
340B ID
RWII61265A
Entity Address
4101 John Deere Road
Moline, IL 61265
Grant Number
X09HA32739
Participating Start Date
10/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00484
2250 41ST ST.
MOLINE, IL 61265
Pharmacy Comments
Contract Details
Approval Date
4/7/2021
Contract Begin Date
6/3/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/19/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Andrea Jo Meirick, Executive Director
(309) 762-5433
Contract Pharmacy Representative
CVSHealth
Christina Reid, 340B Program Director
(401) 770-2118
Signed By Date
4/7/2021
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