340B Drug Pricing Program Database
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
FQHCLA421D TARZANA TREATMENT CENTER, INC. - information as of 4/29/2025 1:43:04 AM
Covered Entity Details
Entity Name
TARZANA TREATMENT CENTER, INC.
Subdivision Name
Primary Healthcare Services @ Tarzana Treatment Centers
Type
Health Center Program Look-Alike
340B ID
FQHCLA421D
Entity Address
18646 Oxnard St
Tarzana, CA 91356-1411
Grant Number
LALCS40177
Participating Start Date
4/1/2021
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
Pharmacy Address
CAREMARK, LLC
1001 SPINKS ROAD, STE 280
FLOWER MOUND, TX 75028
Pharmacy Comments
Contract Details
Approval Date
3/5/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ALBERT M. SENELLA, PRESIDENT AND CEO
(818) 654-3815
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/29/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session