Contract Pharmacy Details

HIGHLAND PARK CVS, L.L.C.
CHC29004-07 HOWARD BROWN HEALTH CENTER

Covered Entity Details

Entity Name

HOWARD BROWN HEALTH CENTER

Subdivision Name

Howard Brown Health Diversey

Type

HRSA-Funded Health Center

340B ID

CHC29004-07

Entity Address

2800 N Sheridan Rd, Ste 211
Chicago, IL 60657

Grant Number

H80CS29004

Participating Start Date

1/1/2018

Last Recertification Date

2/14/2024

Entity Termination Date

10/1/2024

Pharmacy Details

Pharmacy Name

HIGHLAND PARK CVS, L.L.C.

Pharmacy Address

CVS PHARMACY # 17437
4466 N BROADWAY ST
CHICAGO, IL 60640

Pharmacy Comments

Contract Details

Approval Date

10/11/2022

Contract Begin Date

1/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Anthony Scott Armstrong, Vice President of Strategy and Business Development
(407) 765-5579

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/11/2022

340B Drug Pricing Program Database