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CAREMARK, L.L.C.
PED053301-00 CHILDRENS HOSP & RES CNTR OAKLAND
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Covered Entity Details
Entity Name
CHILDRENS HOSP & RES CNTR OAKLAND
Subdivision Name
Type
Children's Hospital
340B ID
PED053301-00
Entity Address
747 52ND STREET
OAKLAND, CA 94609-1809
Medicare Provider Number
053301
Participating Start Date
10/1/2019
Last Recertification Date
8/12/2024
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
7/14/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jamie Christine Phillips, Chief Operating Officer
(415) 353-9116
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2021
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