340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SWEDISH COVENANT HEALTH
DSH140114C SWEDISH COVENANT HEALTH
Print
Covered Entity Details
Entity Name
SWEDISH COVENANT HEALTH
Subdivision Name
PAIN MANAGEMENT CLINIC
Type
Disproportionate Share Hospital
340B ID
DSH140114C
Entity Address
5215 N. California Ave.
CHICAGO, IL 60625
Medicare Provider Number
140114
Outpatient Facility Provider Number
Participating Start Date
10/14/2008
Last Recertification Date
8/13/2024
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
SWEDISH COVENANT HEALTH
Pharmacy Address
DBA GALTER MEDICAL PAVILION PHARMACY
5140 N CALIFORNIA AVE # G105
CHICAGO, IL 60625
Pharmacy Comments
Contract Details
Approval Date
11/4/2008
Contract Begin Date
11/4/2008
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2023
Ownership change
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
10/29/2008
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