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DEITCH PHARMACY INC
CH053210 ERIE FAMILY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
ERIE FAMILY HEALTH CENTER, INC.
Subdivision Name
ERIE WEST TOWN HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH053210
Entity Address
1701 W Superior St
Chicago, IL 60622
Grant Number
H80CS00115
Participating Start Date
1/1/1997
Last Recertification Date
2/23/2025
Pharmacy Details
Pharmacy Name
DEITCH PHARMACY INC
Pharmacy Address
1800 W CHICAGO AVE
CHICAGO, IL 60622
Pharmacy Comments
Contract Details
Approval Date
5/1/2010
Contract Begin Date
5/1/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/30/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
3/30/2010
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