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AHSSHC
DSH140292 UChicago Medicine AdventHealth GlenOaks
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Covered Entity Details
Entity Name
UChicago Medicine AdventHealth GlenOaks
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140292
Entity Address
701 WINTHROP AVENUE
GLENDALE HEIGHTS, IL 60139-1405
Medicare Provider Number
140292
Participating Start Date
7/1/2005
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
AHSSHC
Pharmacy Address
RX PLUS PHARMACY
5050 WESLEY RD STE 110
APOPKA, FL 32712
Pharmacy Comments
Contract Details
Approval Date
4/14/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vladimir Radivojevic, President & CEO
(630) 545-7258
Contract Pharmacy Representative
Advent Health
Trenia Yileding, CP Executive Director RX Plus
(407) 357-2601
Signed By Date
4/14/2022
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