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AMERICAN DRUG STORES LLC
CH0512780 Tapestry 360 Health
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Covered Entity Details
Entity Name
Tapestry 360 Health
Subdivision Name
Tapestry 360 Health - Administration
Type
HRSA-Funded Health Center
340B ID
CH0512780
Entity Address
1301 W Devon Ave
Chicago, IL 60660
Grant Number
H80CS00215
Participating Start Date
1/1/2004
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
AMERICAN DRUG STORES LLC
Pharmacy Address
DBA OSCO DRUG 230
7530 S STONY ISLAND AVE
CHICAGO, IL 60649
Pharmacy Comments
Contract Details
Approval Date
10/14/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nicole Willis, CEO
(312) 256-3496
Contract Pharmacy Representative
SAFEWAY
Charles Hanson, 340B Program Manager
(208) 395-6304
Signed By Date
10/14/2022
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