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CAREMARK, L.L.C.
STD33936 Blue Star Health
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Covered Entity Details
Entity Name
Blue Star Health
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33936
Entity Address
1154 Lee Blvd Unit 3
Lehigh Acres, FL 33936
Grant Number
NH25PS005131
Participating Start Date
1/1/2021
Last Recertification Date
5/15/2024
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
4/4/2022
Contract Begin Date
4/5/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/15/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Fabio Ruiz, CEO
(866) 725-4642
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/4/2022
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