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ADVOCATE HOME CARE PRODUCTS
DSH140208 ADVOCATE CHRIST MEDICAL CENTER
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Covered Entity Details
Entity Name
ADVOCATE CHRIST MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140208
Entity Address
4440 W 95TH ST
OAK LAWN, IL 60453
Medicare Provider Number
140208
Participating Start Date
7/1/2011
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
ADVOCATE HOME CARE PRODUCTS
Pharmacy Address
1441 BRANDING AVE STE 310
DOWNERS GROVE, IL 60515-5624
Pharmacy Comments
Contract Details
Approval Date
7/19/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/14/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
ROBERT PEKOFSKE, VP FINANCE
(708) 684-5133
Contract Pharmacy Representative
Paul Miller, Pharmacy Manager
(630) 829-4535
Signed By Date
7/19/2016
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