340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HIGHLAND PARK CVS, L.L.C.
CH057260A KENOSHA COMMUNITY HEALTH CENTER INC
Print
Covered Entity Details
Entity Name
KENOSHA COMMUNITY HEALTH CENTER INC
Subdivision Name
Kenosha Community Center Clinic
Type
HRSA-Funded Health Center
340B ID
CH057260A
Entity Address
1330 52nd Street STE 205
Kenosha, WI 53140-3236
Grant Number
H80CS00662
Participating Start Date
10/1/2013
Last Recertification Date
2/22/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02797
9640 N MILWAUKEE AVE.
NILES, IL 60714
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Gary Moss, Chief Financial Officer
(262) 764-3619
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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