Contract Pharmacy Details

CAREMARK, L.L.C.
DSH410007 RHODE ISLAND HOSPITAL

Covered Entity Details

Entity Name

RHODE ISLAND HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH410007

Entity Address

593 EDDY STREET
PROVIDENCE, RI 02903

Medicare Provider Number

410007

Participating Start Date

4/1/2004

Last Recertification Date

8/19/2024

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

7/15/2021

Contract Begin Date

7/26/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Mary Wakefield, Senior VP and CFO
(401) 444-7093

Contract Pharmacy Representative

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

Signed By Date

7/15/2021

340B Drug Pricing Program Database