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HIGHLAND PARK CVS, L.L.C.
CH05930A FAMILY CHRISTIAN HEALTH CENTER
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Covered Entity Details
Entity Name
FAMILY CHRISTIAN HEALTH CENTER
Subdivision Name
Family Christian Health Center
Type
HRSA-Funded Health Center
340B ID
CH05930A
Entity Address
713 E. 142nd St.
Dolton, IL 60419-1062
Grant Number
H80CS00879
Participating Start Date
10/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 07166
250 W. 144TH ST.
RIVERDALE, IL 60827
Pharmacy Comments
Contract Details
Approval Date
4/29/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lisa Green, CEO
(708) 339-5525
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/29/2024
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