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AMERICAN DRUG STORES LLC
CHC00341-00 PRIMECARE COMMUNITY HEALTH INC
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Covered Entity Details
Entity Name
PRIMECARE COMMUNITY HEALTH INC
Subdivision Name
PRIMECARE WEST TOWN
Type
HRSA-Funded Health Center
340B ID
CHC00341-00
Entity Address
1431 N Western Ave
Ste 406
Chicago, IL 60622
Grant Number
H80CS00341
Participating Start Date
4/1/2013
Last Recertification Date
2/10/2025
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
10/8/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael C Holtrop, Chief Financial Officer
(616) 482-9892
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
10/8/2024
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