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AMERICAN DRUG STORES LLC
FQHCLA479 MIDWEST REFUAH HEALTH CENTER
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Covered Entity Details
Entity Name
MIDWEST REFUAH HEALTH CENTER
Subdivision Name
Midwest Refuah Health Center- Behavioral Health
Type
Health Center Program Look-Alike
340B ID
FQHCLA479
Entity Address
6374 N Lincoln Ave, Ste 305
Chicago, IL 60659-1283
Grant Number
LALCS54728
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
AMERICAN DRUG STORES LLC
Pharmacy Address
DBA OSCO DRUG 3487
2491 HOWARD ST
EVANSTON, IL 60202
Pharmacy Comments
Contract Details
Approval Date
3/10/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ned Schoenfeld, CEO
(872) 270-5999
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
1/14/2025
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