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CAREMARK, L.L.C.
RWI20012 Casa Ruby, Inc.
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Covered Entity Details
Entity Name
Casa Ruby, Inc.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI20012
Entity Address
7530 Georgia Avenue NW
Washington, DC 20012
Grant Number
H89HA00012
Participating Start Date
1/1/2021
Last Recertification Date
2/28/2021
Entity Termination Date
4/1/2022
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
10/20/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Ruby Corado, Executive Director
(202) 641-8028
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/20/2021
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