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CAREMARK, L.L.C.
DSH370016 INTEGRIS HEALTH ENID HOSPITAL
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Covered Entity Details
Entity Name
INTEGRIS HEALTH ENID HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH370016
Entity Address
600 S MONROE ST
ENID, OK 73701-7211
Medicare Provider Number
370016
Participating Start Date
10/1/2009
Last Recertification Date
8/20/2024
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
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/15/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Chris Hammes, Executive Vice President
(405) 949-3400
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2020
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