Contract Pharmacy Details

AMERICAN DRUG STORES LLC
CH071170 COMMUNITY HEALTH CARE, INC.

Covered Entity Details

Entity Name

COMMUNITY HEALTH CARE, INC.

Subdivision Name

Community Health Care, Inc. River Drive Clinic

Type

HRSA-Funded Health Center

340B ID

CH071170

Entity Address

500 W River Dr
Davenport, IA 52801

Grant Number

H80CS00670

Participating Start Date

12/1/1992

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

AMERICAN DRUG STORES LLC

Pharmacy Address

DBA OSCO DRUG 122
2010 1ST ST STE A
MOLINE, IL 61265

Pharmacy Comments

Contract Details

Approval Date

7/5/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/9/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Thomas Bowman, CEO
(563) 336-3112

Contract Pharmacy Representative

Safeway
charles Hanson, 340B program manager
(208) 395-6304

Signed By Date

7/5/2023

340B Drug Pricing Program Database