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BIENESTAR PHARMACY III INC.
CH056620 ALIVIO MEDICAL CENTER, INC
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Covered Entity Details
Entity Name
ALIVIO MEDICAL CENTER, INC
Subdivision Name
ALIVIO MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH056620
Entity Address
2355 S. WESTERN AVE
CHICAGO, IL 60608-3837
Grant Number
H80CS00116
Participating Start Date
7/1/1998
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
BIENESTAR PHARMACY III INC.
Pharmacy Address
2359 S WESTERN AVE STE 100
CHICAGO, IL 60608
Pharmacy Comments
Contract Details
Approval Date
5/31/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sandra I. Flores, Director of Development
(312) 829-6370
Contract Pharmacy Representative
Bienestar Pharmacy
Snejal Bhavsar, Senior Associate
(630) 452-3938
Signed By Date
5/31/2017
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