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CAREMARK, L.L.C.
CH096040 COMMUNITY CLINIC OF MAUI
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Covered Entity Details
Entity Name
COMMUNITY CLINIC OF MAUI
Subdivision Name
Community Clinic of Maui
Type
HRSA-Funded Health Center
340B ID
CH096040
Entity Address
1881 Nani St
Wailuku, HI 96793-1811
Grant Number
H80CS00722
Participating Start Date
4/1/2004
Last Recertification Date
2/25/2025
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
4/2/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BJ OTT, CHIEF EXECUTIVE OFFICER
(808) 872-4018
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/2/2021
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