340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC
DSH160083 CATHOLIC HEALTH INITIATIVES - IOWA, CORP
Print
Covered Entity Details
Entity Name
CATHOLIC HEALTH INITIATIVES - IOWA, CORP
Subdivision Name
MERCYONE DES MOINES MEDICAL CENTER
Type
Disproportionate Share Hospital
340B ID
DSH160083
Entity Address
1111 6th Avenue
DES MOINES, IA 50314-2610
Medicare Provider Number
160083
Participating Start Date
4/1/2011
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC
Pharmacy Address
DBA CVS/CAREMARK 48067
1780 WALL ST
MT PROSPECT, IL 60056
Pharmacy Comments
Contract Details
Approval Date
7/14/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Randall Rubin, Senior Vice President Chief Financial Officer
(515) 643-2860
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2022
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session