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CAREMARK NORTH CAROLINA SPECIALTY PHARMA
DSH330005 KALEIDA HEALTH
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Covered Entity Details
Entity Name
KALEIDA HEALTH
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330005
Entity Address
100 High Street
BUFFALO, NY 14203
Medicare Provider Number
330005
Participating Start Date
4/1/2006
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
CAREMARK NORTH CAROLINA SPECIALTY PHARMA
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
10700 WORLD TRADE BLVD STE 110
RALEIGH, NC 27617
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul E Belter, EVP Chief Financial Officer
(716) 859-8836
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2021
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