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CAREMARK KANSAS SPECIALTY PHARMACY
CH021887Q SUNSET PARK HEALTH COUNCIL, INC.
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Covered Entity Details
Entity Name
SUNSET PARK HEALTH COUNCIL, INC.
Subdivision Name
CALLEN LORDE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH021887Q
Entity Address
356 W 18th St
New York, NY 10011-4401
Grant Number
H80CS07914
Participating Start Date
4/1/2004
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
CAREMARK KANSAS SPECIALTY PHARMACY
Pharmacy Address
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
11162 RENNER BLVD
LENEXA, KS 66219
Pharmacy Comments
Contract Details
Approval Date
1/7/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Larry K. McReynolds, Executive Director
(718) 630-7216
Contract Pharmacy Representative
Caremark
Sandy Campa, Providership Supervisor
(909) 799-4174
Signed By Date
1/7/2021
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