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PRIME THERAPEUTICS SPECIALTY PHARMACY LL
CH059300 FAMILY CHRISTIAN HEALTH CENTER
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Covered Entity Details
Entity Name
FAMILY CHRISTIAN HEALTH CENTER
Subdivision Name
FAMILY CHRISTIAN HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH059300
Entity Address
31 W 155th St
Harvey, IL 60426-3556
Grant Number
H80CS00879
Participating Start Date
4/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
PRIME THERAPEUTICS SPECIALTY PHARMACY LL
Pharmacy Address
ALLIANCERX WALGREENS PRIME #16568
2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDO, FL 32819-9992
Pharmacy Comments
Contract Details
Approval Date
1/16/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Lisa Green, CEO
(708) 339-5525
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/16/2022
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