340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PROVIDENT HOSPITAL OF COOK COUNTY
DSH140124AE JOHN H. STROGER, JR. HOSPITAL OF COOK COUNTY
Print
Covered Entity Details
Entity Name
JOHN H. STROGER, JR. HOSPITAL OF COOK COUNTY
Subdivision Name
Professional Building - Breast/Surgical Oncology - Surgery Oncology
Type
Disproportionate Share Hospital
340B ID
DSH140124AE
Entity Address
1950 West Polk Street
Chicago, IL 60612
Medicare Provider Number
140124
Outpatient Facility Provider Number
Participating Start Date
1/1/2023
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
PROVIDENT HOSPITAL OF COOK COUNTY
Pharmacy Address
ATTENTION PHARMACY DEPARTMENT
500 E 51ST ST
ROOM 2050
CHICAGO, IL 60615-2400
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Pamela Cassara, Chief Financial Officer
(312) 864-5507
Contract Pharmacy Representative
Cook County Health & Hospitals System
CaTanya Norwood, Senior Director of Pharmacy
(312) 864-2213
Signed By Date
10/11/2023
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