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HIGHLAND PARK CVS, L.L.C.
CH051827A ASIAN HUMAN SERVICES FAMILY HEALTH CENTER
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Covered Entity Details
Entity Name
ASIAN HUMAN SERVICES FAMILY HEALTH CENTER
Subdivision Name
AHS Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH051827A
Entity Address
6301 N. Western Ave.
Chicago, IL 60659-2009
Grant Number
H80CS02327
Participating Start Date
4/1/2004
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08751
4051 N LINCOLN
CHICAGO, IL 60618
Pharmacy Comments
Contract Details
Approval Date
1/7/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Muhammad W Paracha, CEO
(773) 761-0010
Contract Pharmacy Representative
CVS
Charles Basralian, Acct Manager
(401) 772-7343
Signed By Date
1/7/2022
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