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HIGHLAND PARK CVS, L.L.C.
CH051278A Tapestry 360 Health
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Covered Entity Details
Entity Name
Tapestry 360 Health
Subdivision Name
Tapestry 360 Health - SENN HIGH SCHOOL
Type
HRSA-Funded Health Center
340B ID
CH051278A
Entity Address
5900 N GLENWOOD
CHICAGO, IL 60660
Grant Number
H80CS00215
Participating Start Date
7/1/2008
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05001
3033 N. BROADWAY ST.
CHICAGO, IL 60657
Pharmacy Comments
Contract Details
Approval Date
4/13/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nicole Willis, CEO
(312) 256-3496
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/13/2021
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