Contract Pharmacy Details

CAREMARK KANSAS SPECIALTY PHARMACY
CH020110 WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.

Covered Entity Details

Entity Name

WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.

Subdivision Name

WHITNEY M. YOUNG, JR. HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH020110

Entity Address

920 Lark Dr
Albany, NY 12207-1300

Grant Number

H80CS00433

Participating Start Date

10/1/1995

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

CAREMARK KANSAS SPECIALTY PHARMACY

Pharmacy Address

CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
11162 RENNER BLVD
LENEXA, KS 66219

Pharmacy Comments

Contract Details

Approval Date

7/15/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

David H. Shippee, President & CEO
(518) 591-4459

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/15/2019

340B Drug Pricing Program Database