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HIGHLAND PARK CVS, L.L.C.
RWII61265A The Project of the Quad Cities
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Covered Entity Details
Entity Name
The Project of the Quad Cities
Subdivision Name
Type
Ryan White Part B
340B ID
RWII61265A
Entity Address
4101 John Deere Road
Moline, IL 61265
Grant Number
X09HA32739
Participating Start Date
10/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08656
2617 18TH AVE.
ROCK ISLAND, IL 61201
Pharmacy Comments
Contract Details
Approval Date
10/17/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Caitlin Brady Wells, Chief Executive Officer
(309) 581-2030
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/17/2022
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