340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HIGHLAND PARK CVS, L.L.C.
CHC00341-00 PRIMECARE COMMUNITY HEALTH INC
Print
Covered Entity Details
Entity Name
PRIMECARE COMMUNITY HEALTH INC
Subdivision Name
PRIMECARE WEST TOWN
Type
HRSA-Funded Health Center
340B ID
CHC00341-00
Entity Address
1431 N Western Ave
Ste 406
Chicago, IL 60622
Grant Number
H80CS00341
Participating Start Date
4/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
CVS/PHARMACY # 10942
310 SOUTH MICHIGAN AVE
CHICAGO, IL 60604
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
Michael C Holtrop, Chief Financial Officer
(616) 482-9892
Contract Pharmacy Representative
Wellpartner
Bryn Wolgemuth, Account Manager
(917) 607-0428
Signed By Date
4/14/2022
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session