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UNITED RX LLC
RWII60644 Taskforce Prevention and Community Services
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Covered Entity Details
Entity Name
Taskforce Prevention and Community Services
Subdivision Name
HIV/AIDS
Type
Ryan White Part B
340B ID
RWII60644
Entity Address
9 N Cicero Ave
Chicago, IL 60644
Grant Number
X07HA00013-27-00
Participating Start Date
4/1/2024
Last Recertification Date
2/16/2025
Pharmacy Details
Pharmacy Name
UNITED RX LLC
Pharmacy Address
150 FENCL LN
HILLSIDE, IL 60162
Pharmacy Comments
Contract Details
Approval Date
1/6/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher Balthazar, Executive Director
(504) 432-5420
Contract Pharmacy Representative
UNITED/XCEL-RX LLC
Tina Anatolitis, Pharmacy Manager
(708) 564-5052
Signed By Date
1/6/2025
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