Contract Pharmacy Details

PHARMACY ONE PLUS
CH051278E Tapestry 360 Health

Covered Entity Details

Entity Name

Tapestry 360 Health

Subdivision Name

Tapestry 360 Health - LINCOLN SQUARE

Type

HRSA-Funded Health Center

340B ID

CH051278E

Entity Address

2645 W. LAWRENCE
CHICAGO, IL 60625

Grant Number

H80CS00215

Participating Start Date

4/1/2009

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

PHARMACY ONE PLUS

Pharmacy Address

THURAYA, INC
4753-55 N KEDZIE AVE
CHICAGO, IL 60625

Pharmacy Comments

Contract Details

Approval Date

8/22/2011

Contract Begin Date

8/22/2011

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Gwenn Rausch, Executive Director
(773) 296-8589

Contract Pharmacy Representative

Jawad Rabi, Owner
(773) 267-5050

Signed By Date

8/18/2011