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CAREMARK, L.L.C.
SCH200050-00 MAINE COAST MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
MAINE COAST MEMORIAL HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH200050-00
Entity Address
50 UNION STREET
ELLSWORTH, ME 04605
Medicare Provider Number
200050
Participating Start Date
4/1/2020
Last Recertification Date
9/9/2024
Entity Termination Date
7/1/2025
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
1/8/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Wendy J Jones, VP of Finance
(207) 374-3409
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/8/2021
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