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PHARMACY ONE PLUS
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
PHARMACY ONE PLUS
Pharmacy Address
THURAYA, INC
4753-55 N KEDZIE AVE
CHICAGO, IL 60625
Pharmacy Comments
Contract Details
Approval Date
1/9/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lee Francis, President & CEO
(312) 432-7394
Contract Pharmacy Representative
PHARMACY ONE
Ray Dahabra, Manager
(773) 267-5050
Signed By Date
1/9/2017
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