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GOLDENSONS MORSE L DRUGS
CH051278L Tapestry 360 Health
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Covered Entity Details
Entity Name
Tapestry 360 Health
Subdivision Name
Tapestry 360 Health - Devon
Type
HRSA-Funded Health Center
340B ID
CH051278L
Entity Address
1300 W Devon Ave
Chicago, IL 60660-1302
Grant Number
H80CS00215
Participating Start Date
4/1/2015
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
GOLDENSONS MORSE L DRUGS
Pharmacy Address
HERMAN GOLDENSON
MORSE L DRUGS
1407 MORSE AVE
CHICAGO, IL 60626
Pharmacy Comments
Contract Details
Approval Date
1/20/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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