Contract Pharmacy Details

NORTH CAROLINA CVS PHARMACY, L.L.C.
DSH340070 ALAMANCE REGIONAL MEDICAL CENTER

Covered Entity Details

Entity Name

ALAMANCE REGIONAL MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH340070

Entity Address

1240 HUFFMAN MILL ROAD
BURLINGTON, NC 27215

Medicare Provider Number

340070

Participating Start Date

7/1/2015

Last Recertification Date

8/29/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

NORTH CAROLINA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 07053
904 SOUTH 5TH ST.
MEBANE, NC 27302

Pharmacy Comments

Contract Details

Approval Date

7/15/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Jeffrey Jones, Executive VP and CFO
(336) 832-8005

Contract Pharmacy Representative

Caremark L.L.C.
Christian reid, 340b Program Director
(401) 770-2118

Signed By Date

7/15/2020

340B Drug Pricing Program Database