340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-1933
CHC26565-01 Hamdard Health Alliance
Print
Covered Entity Details
Entity Name
Hamdard Health Alliance
Subdivision Name
Hamdard Health Rogers Park
Type
HRSA-Funded Health Center
340B ID
CHC26565-01
Entity Address
1542 W Devon Ave
Chicago, IL 60660-1344
Grant Number
H80CS26565
Participating Start Date
4/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1933
Pharmacy Address
137 WEST NORTH AVENUE
NORTHLAKE, IL 60164
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kiran S. Siddique, COO
(773) 465-4600 Ext: 227
Contract Pharmacy Representative
Caremark LLC
Christina Reddi, Account Manager
(347) 380-3546
Signed By Date
1/13/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session