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CAREMARK PUERTO RICO SPECIALTY PHARMACY,
CH011990 BLACKSTONE VALLEY COMMUNITY HEALTH CARE
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Covered Entity Details
Entity Name
BLACKSTONE VALLEY COMMUNITY HEALTH CARE
Subdivision Name
Blackstone Valley Community Health Care
Type
HRSA-Funded Health Center
340B ID
CH011990
Entity Address
39 EAST AVENUE
PAWTUCKET, RI 02860
Grant Number
H80CS00154
Participating Start Date
10/1/2003
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CAREMARK PUERTO RICO SPECIALTY PHARMACY,
Pharmacy Address
CAREMARK PUERTO RICO SPECIALTY PHARMACY
6020 AVE ROBERTO SANCHEZ VILELLA
CAROLINA, PR 00982
Pharmacy Comments
Contract Details
Approval Date
7/3/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Raymond Joseph Lavoie, EXECUTIVE DIRECTOR
(401) 729-5235
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/3/2020
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