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CAREMARK ILLINOIS SPECIALTY PHARMACY, LL
CH011460 LOWELL COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
LOWELL COMMUNITY HEALTH CENTER, INC.
Subdivision Name
ACCOUNTS PAYABLE
Type
HRSA-Funded Health Center
340B ID
CH011460
Entity Address
161 Jackson Street
LOWELL, MA 01852-2103
Grant Number
H80CS00397
Participating Start Date
4/1/1997
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CAREMARK ILLINOIS SPECIALTY PHARMACY, LL
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
800 BIERMANN CT STE B
MOUNT PROSPECT, IL 60056
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Henry Och, Chief of Operations
(978) 322-8519
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2020
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