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HIGHLAND PARK CVS, L.L.C.
CAH141316-00 Carle Hoopeston Regional Health Center
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Covered Entity Details
Entity Name
Carle Hoopeston Regional Health Center
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH141316-00
Entity Address
701 East Orange Street
Hoopeston, IL 60942
Medicare Provider Number
141316
Participating Start Date
7/1/2013
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06936
900 E. MAIN ST.,
DANVILLE, IL 61832
Pharmacy Comments
Contract Details
Approval Date
10/14/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Dennis P. Hesch, Executive VP and CFO
(217) 326-8231
Contract Pharmacy Representative
Scott Tierney, Senior Director, Payer Relations
(401) 770-2762
Signed By Date
10/14/2013
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