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NORTH CAROLINA CVS PHARMACY, L.L.C.
DSH340070 ALAMANCE REGIONAL MEDICAL CENTER
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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 # 05377
204 LIBERTY PLAZA, PO BOX 1128
LIBERTY, NC 27298
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
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