Contract Pharmacy Details

UNITED RX LLC
STD60004 Equity Alliance Health of Illinois

Covered Entity Details

Entity Name

Equity Alliance Health of Illinois

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD60004

Entity Address

1618 N Rand Road
Arlington Heights, IL 60004

Grant Number

5 NH25PS005128-03-00

Participating Start Date

4/1/2025

Last Recertification Date

5/6/2025

Pharmacy Details

Pharmacy Name

UNITED RX LLC

Pharmacy Address

150 FENCL LN
HILLSIDE, IL 60162

Pharmacy Comments

Contract Details

Approval Date

2/12/2025

Contract Begin Date

4/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Richard J Jordan, CFO
(708) 525-7362

Contract Pharmacy Representative

United/XCel-Rx, LLC
Chuck Benain, Chief Operating Officer
(708) 449-7600 Ext: 373

Signed By Date

1/15/2025

340B Drug Pricing Program Database