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HIGHLAND PARK CVS, L.L.C.
CH051750 ACCESS COMMUNITY HEALTH NETWORK
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Covered Entity Details
Entity Name
ACCESS COMMUNITY HEALTH NETWORK
Subdivision Name
ADMINISTRATIVE OFFICES
Type
HRSA-Funded Health Center
340B ID
CH051750
Entity Address
600 W Fulton
STE 300
CHICAGO, IL 60661
Grant Number
H80CS00834
Participating Start Date
7/1/2004
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08519
11055 S. WESTERN AVENUE
CHICAGO, IL 60643
Pharmacy Comments
Contract Details
Approval Date
1/20/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/12/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
DONNA THOMPSON, CEO
(312) 526-2051
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/20/2022
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