Contract Pharmacy Details

AMERICAN DRUG STORES LLC
CH0512780 Tapestry 360 Health

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

OSCO DRUG #3538
1763 W HOWARD ST
CHICAGO, IL 60626-1626

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

340B Drug Pricing Program Database