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CAREMARK KANSAS SPECIALTY PHARMACY
FQHCLA434D MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.
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Covered Entity Details
Entity Name
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.
Subdivision Name
MAHEC Cane Creek Primary Care Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA434D
Entity Address
1542 Cane Creek Rd
Fletcher, NC 28732-7423
Grant Number
LALCS45788
Participating Start Date
10/1/2022
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
CAREMARK KANSAS SPECIALTY PHARMACY
Pharmacy Address
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
11162 RENNER BLVD
LENEXA, KS 66219
Pharmacy Comments
Contract Details
Approval Date
10/7/2022
Contract Begin Date
11/15/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
William R Hathaway, CEO
(828) 257-4405
Contract Pharmacy Representative
Wellpartner
Kenneth Bodmer, Vice President
(877) 805-9483
Signed By Date
10/7/2022
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