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CAREMARK, L.L.C.
SCH060071-00 DELTA COUNTY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
DELTA COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH060071-00
Entity Address
1501 E. 3RD ST.
DELTA, CO 81416
Medicare Provider Number
060071
Participating Start Date
7/1/2025
Last Recertification Date
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
9/6/2022
Contract Begin Date
9/12/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Matthew Heyn, CEO
(970) 874-2229
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
9/6/2022
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