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CAREMARK MICHIGAN SPECIALTY PHARMACY, LL
CHC10591-02 COMMUNITY CLINIC, INC.
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Covered Entity Details
Entity Name
COMMUNITY CLINIC, INC.
Subdivision Name
CCI-GAITHERSBURG
Type
HRSA-Funded Health Center
340B ID
CHC10591-02
Entity Address
220 GIRARD ST
Suite 100
GAITHERSBURG, MD 20877
Grant Number
H80CS10591
Participating Start Date
7/1/2009
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CAREMARK MICHIGAN SPECIALTY PHARMACY, LL
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
1307 ALLEN DR STE H
TROY, MI 48083
Pharmacy Comments
Contract Details
Approval Date
1/18/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sonya J. Bruton, CEO and President
(240) 839-5107
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/18/2022
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