340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CAREMARK MICHIGAN SPECIALTY PHARMACY, LL
DSH140018 MOUNT SINAI HOSPITAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
MOUNT SINAI HOSPITAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140018
Entity Address
2750 W 15TH PLACE
CHICAGO, IL 60608-1797
Medicare Provider Number
140018
Participating Start Date
10/1/2004
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
CAREMARK MICHIGAN SPECIALTY PHARMACY, LL
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
1307 ALLEN DR STE H
TROY, MI 48083
Pharmacy Comments
Contract Details
Approval Date
6/6/2019
Contract Begin Date
6/7/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lori Pacura, President of Acute Care Hospitals
(773) 257-2914
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
6/6/2019
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