340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HEENA VITAL RX, INC
STD60615 Brave Space Alliance
Print
Covered Entity Details
Entity Name
Brave Space Alliance
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD60615
Entity Address
1515 E. 52nd pl
chicago, IL 60615
Grant Number
NU62PS924821
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
HEENA VITAL RX, INC
Pharmacy Address
DBA VITAL SPECIALTY PHARMACY
1525 E 55TH ST STE 103
CHICAGO, IL 60615-5514
Pharmacy Comments
Contract Details
Approval Date
4/8/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Channyn Lynne Parker, CEO
(872) 333-5199
Contract Pharmacy Representative
Vital RX
Anup Doshi, President
(773) 862-1699
Signed By Date
4/8/2025
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session