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CAREMARK, L.L.C.
HV00018 The Miriam Hospital
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Covered Entity Details
Entity Name
The Miriam Hospital
Subdivision Name
Ryan White Care Program
Type
Ryan White Part C
340B ID
HV00018
Entity Address
180 Corliss St.
Suite E
Providence, RI 02904
Grant Number
H76HA00018
Participating Start Date
7/1/2014
Last Recertification Date
2/13/2025
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
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mary Wakefield, Senior VP and CFO
(401) 444-7093
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2020
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