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AURORA SPECIALTY PHARMACY
DSH140208 ADVOCATE CHRIST MEDICAL CENTER
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Covered Entity Details
Entity Name
ADVOCATE CHRIST MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140208
Entity Address
4440 W 95TH ST
OAK LAWN, IL 60453
Medicare Provider Number
140208
Participating Start Date
7/1/2011
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
AURORA SPECIALTY PHARMACY
Pharmacy Address
N93W14575 WHITTAKER WAY
MENOMONEE FALLS, WI 53051-1652
Pharmacy Comments
Contract Details
Approval Date
4/9/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ROBERT PEKOFSKE, VP FINANCE
(708) 684-5133
Contract Pharmacy Representative
Aurora Health Care
Angela De Ianni, Director, Pharmacy Supply Chain
(414) 382-1854
Signed By Date
4/9/2018
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