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CAREMARK MASSACHUSETTS SPECIALTY PHARMAC
RWII60608 Alliance Care 360
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Covered Entity Details
Entity Name
Alliance Care 360
Subdivision Name
Type
Ryan White Part B
340B ID
RWII60608
Entity Address
2929 S Wabash Avenue
Suite
202
Chicago, IL 60616-2327
Grant Number
X07HA00013-27-00
Participating Start Date
4/1/2016
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
CAREMARK MASSACHUSETTS SPECIALTY PHARMAC
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
25 BIRCH STREET, BLDG B, SUITE 100
MILFORD, MA 01757
Pharmacy Comments
Contract Details
Approval Date
7/13/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/29/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ariq Cabbler, Director
(312) 808-1044 Ext: 101
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/13/2020
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