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CAREMARK, L.L.C.
CAH131325-00 BMH, INC. DBA BINGHAM MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
BMH, INC. DBA BINGHAM MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH131325-00
Entity Address
98 POPLAR
BLACKFOOT, ID 83221
Medicare Provider Number
131325
Participating Start Date
9/8/2010
Last Recertification Date
8/14/2024
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
10/16/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jake Erickson, CEO
(208) 785-3803
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2021
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