340B Drug Pricing Program Database
CAREMARK NEW JERSEY SPECIALTY PHCY, LLC
DSH180035 ST ELIZABETH HEALTHCARE - information as of 5/16/2025 1:22:54 AM
Covered Entity Details
Entity Name
ST ELIZABETH HEALTHCARE
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180035
Entity Address
1 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017-3403
Medicare Provider Number
180035
Participating Start Date
10/1/2016
Last Recertification Date
8/20/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
CAREMARK NEW JERSEY SPECIALTY PHCY, LLC
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
180 PASSAIC AVE UNIT B-5
FAIRFIELD, NJ 07004
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lori Ritchey-Baldwin, CFO
(859) 655-1642
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2019
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