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HIGHLAND PARK CVS, L.L.C.
RWI606161 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
AHF HEALTHCARE CENTER - CHICAGO
Type
Ryan White Part A
340B ID
RWI606161
Entity Address
2600 S. MICHIGAN AVE.
Suite 416
CHICAGO, IL 60616
Grant Number
H89HA00008
Participating Start Date
1/1/2016
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03170
6417 W. HIGGINS AVE.
CHICAGO, IL 60656
Pharmacy Comments
Contract Details
Approval Date
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/17/2023
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