Contract Pharmacy Details

CAREMARK, L.L.C.
CAH051315-00 TRINITY HOSPITAL

Covered Entity Details

Entity Name

TRINITY HOSPITAL

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH051315-00

Entity Address

60 EASTER AVENUE
WEAVERVILLE, CA 96093

Medicare Provider Number

051315

Participating Start Date

10/1/2014

Last Recertification Date

8/22/2023

Entity Termination Date

1/1/2024

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

4/5/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/30/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Jennifer Van Matre, Chief Financial Officer
(530) 623-5541 Ext: 3232

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/5/2021

340B Drug Pricing Program Database