Contract Pharmacy Details

CAREMARK, L.L.C.
CAH051333-00 Ridgecrest Regional Hospital

Covered Entity Details

Entity Name

Ridgecrest Regional Hospital

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH051333-00

Entity Address

1081 N. China Lake Blvd.
Ridgecrest, CA 93555

Medicare Provider Number

051333

Participating Start Date

10/1/2013

Last Recertification Date

8/15/2024

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

5/19/2022

Contract Begin Date

5/20/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Celia Mary Mills, Administrator of Care Coordination and Community Health
(760) 499-3960

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

5/19/2022

340B Drug Pricing Program Database