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HIGHLAND PARK CVS, L.L.C.
STD61265 The Project of the Quad Cities
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Covered Entity Details
Entity Name
The Project of the Quad Cities
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD61265
Entity Address
4101 John Deere Road
Suite 3
Moline, IL 61265
Grant Number
6 NU62PS003681-05-01
Participating Start Date
1/1/2017
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #18097
6410 E STATE ST
ROCKFORD, IL 61108-3008
Pharmacy Comments
Contract Details
Approval Date
4/8/2021
Contract Begin Date
6/3/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/1/2024
Business decision by covered entity and/or pharmacy
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
4/8/2021
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