Contract Pharmacy Details

DELIVERCARERX PHARMACY LLC
CH093030 ADELANTE HEALTHCARE, INC.

Covered Entity Details

Entity Name

ADELANTE HEALTHCARE, INC.

Subdivision Name

Adelante Healthcare

Type

HRSA-Funded Health Center

340B ID

CH093030

Entity Address

3033 N. Central Ave.
Phoenix, AZ 85012-4403

Grant Number

H80CS00140

Participating Start Date

12/1/1992

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

DELIVERCARERX PHARMACY LLC

Pharmacy Address

DELIVERCARERX PHARMACY LLC
1471 E BUSINESS CENTER DR
STE 200
MT PROSPECT, IL 60056

Pharmacy Comments

Contract Details

Approval Date

10/5/2017

Contract Begin Date

1/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/11/2019
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Eric Battis, COO
(623) 583-3001 Ext: 1222

Contract Pharmacy Representative

Agape
Dave Krishna, CEO
(847) 965-1600

Signed By Date

10/5/2017

340B Drug Pricing Program Database