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CAREMARK ILLINOIS SPECIALTY PHARMACY, LL
CHC10591-09 COMMUNITY CLINIC, INC., THE
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Covered Entity Details
Entity Name
COMMUNITY CLINIC, INC., THE
Subdivision Name
CCI-Greenway
Type
HRSA-Funded Health Center
340B ID
CHC10591-09
Entity Address
7474 Greenway Center Drive
STE 300
Greenbelt, MD 20770
Grant Number
H80CS10591
Participating Start Date
1/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CAREMARK ILLINOIS SPECIALTY PHARMACY, LL
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
800 BIERMANN CT STE B
MOUNT PROSPECT, IL 60056
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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