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BOND DRUG COMPANY OF ILLINOIS, L.L.C.
CH057440 PCC COMMUNITY WELLNESS CENTER
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Covered Entity Details
Entity Name
PCC COMMUNITY WELLNESS CENTER
Subdivision Name
PCC Lake Street Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH057440
Entity Address
14 Lake St
Oak Park, IL 60302-2606
Grant Number
H80CS00276
Participating Start Date
7/1/1997
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
BOND DRUG COMPANY OF ILLINOIS, L.L.C.
Pharmacy Address
DBA: WALGREENS # 11410
1627 N PULASKI RD
CHICAGO, IL 60639
Pharmacy Comments
Contract Details
Approval Date
5/7/2012
Contract Begin Date
5/7/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert J. Urso, CEO
(708) 383-9786
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
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