Contract Pharmacy Details

AMERICAN DRUG STORES LLC
CH053210 ERIE FAMILY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

ERIE FAMILY HEALTH CENTER, INC.

Subdivision Name

ERIE WEST TOWN HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH053210

Entity Address

1701 W Superior St
Chicago, IL 60622

Grant Number

H80CS00115

Participating Start Date

1/1/1997

Last Recertification Date

2/23/2025

Pharmacy Details

Pharmacy Name

AMERICAN DRUG STORES LLC

Pharmacy Address

DBA OSCO DRUG 1241
1343 N. PAULINA ST.
CHICAGO, IL 60622

Pharmacy Comments

Contract Details

Approval Date

7/17/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/28/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

David Bruce, Chief Financial & Administrative Officer (CFAO)
(312) 432-2725

Contract Pharmacy Representative

Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304

Signed By Date

7/17/2023

340B Drug Pricing Program Database