Contract Pharmacy Details

HIGHLAND PARK CVS, L.L.C.
CH0512780 Tapestry 360 Health

Covered Entity Details

Entity Name

Tapestry 360 Health

Subdivision Name

Tapestry 360 Health - Administration

Type

HRSA-Funded Health Center

340B ID

CH0512780

Entity Address

1301 W Devon Ave
Chicago, IL 60660

Grant Number

H80CS00215

Participating Start Date

1/1/2004

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

HIGHLAND PARK CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 05978
3434 DEMPSTER ST.
SKOKIE, IL 60076

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

340B Drug Pricing Program Database