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HIGHLAND PARK CVS, L.L.C.
CH052130 CHRISTOPHER RURAL HEALTH PLANNING CORP.
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Covered Entity Details
Entity Name
CHRISTOPHER RURAL HEALTH PLANNING CORP.
Subdivision Name
REA CLINIC
Type
HRSA-Funded Health Center
340B ID
CH052130
Entity Address
4241 HWY 14 WEST
CHRISTOPHER, IL 62822
Grant Number
H80CS00726
Participating Start Date
10/1/1998
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06390
2431 W. MAIN ST.
CARBONDALE, IL 62901
Pharmacy Comments
Contract Details
Approval Date
1/5/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KIMBERLY A. MITROKA, PRESIDENT/CEO
(618) 724-2436 Ext: 1602
Contract Pharmacy Representative
CRHPC
Merideth Rogers, Pharmacy Director
(618) 724-1630
Signed By Date
1/5/2023
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