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CAREMARK NEW JERSEY SPECIALTY PHCY, LLC
CAH491300-00 Bath County Community Hospital, Inc.
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Covered Entity Details
Entity Name
Bath County Community Hospital, Inc.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH491300-00
Entity Address
106 Park Drive
Hot Springs, VA 24445
Medicare Provider Number
491300
Participating Start Date
1/1/2014
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
CAREMARK NEW JERSEY SPECIALTY PHCY, LLC
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
180 PASSAIC AVE UNIT B-5
FAIRFIELD, NJ 07004
Pharmacy Comments
Contract Details
Approval Date
10/11/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tom Vandenhoven, CFO
(540) 839-7138
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/11/2022
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