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SALUD PHARMACY INC.
CH05662D ALIVIO MEDICAL CENTER, INC
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Covered Entity Details
Entity Name
ALIVIO MEDICAL CENTER, INC
Subdivision Name
ALIVIO MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH05662D
Entity Address
966 W 21st St
Chicago, IL 60608-4511
Grant Number
H80CS00116
Participating Start Date
1/1/1998
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
SALUD PHARMACY INC.
Pharmacy Address
4255 W 63RD ST STE 300
CHICAGO, IL 60629
Pharmacy Comments
Contract Details
Approval Date
11/1/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/12/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
ESTHER CORPUZ, CHIEF EXECUTIVE OFFICER
(312) 829-6304
Contract Pharmacy Representative
Bienestar Pharmacy
Snejal Bhavsar, Senior Associate
(630) 452-3938
Signed By Date
11/1/2021
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