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CAREMARK, L.L.C.
RWII19403A Family Service of Montgomery County PA
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Covered Entity Details
Entity Name
Family Service of Montgomery County PA
Subdivision Name
Type
Ryan White Part B
340B ID
RWII19403A
Entity Address
1976 East High Street
Pottstown, PA 19464
Grant Number
X07HA00021
Participating Start Date
7/1/2016
Last Recertification Date
2/12/2020
Entity Termination Date
4/1/2021
Pharmacy Details
Pharmacy Name
CAREMARK, L.L.C.
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
7251 S. EASTERN AVE.
LAS VEGAS, NV 89119
Pharmacy Comments
Contract Details
Approval Date
7/14/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Tim O'Connell, Dir. Special Projects
(610) 630-2111 Ext: 224
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2020
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