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CAREMARK, L.L.C.
DSH330261 PHELPS MEMORIAL HOSPITAL CENTER
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Covered Entity Details
Entity Name
PHELPS MEMORIAL HOSPITAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330261
Entity Address
701 NORTH BROADWAY
SLEEPY HOLLOW, NY 10591
Medicare Provider Number
330261
Participating Start Date
9/2/2008
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
10/16/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michele L Cusack, Executive Vice President
(516) 321-6058
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2020
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