340B Drug Pricing Program Database

Pharmacy Name

CAREMARK ILLINOIS MAIL PHARMACY, LLC

Pharmacy Address

DBA CVS/CAREMARK OR CARELONRX MAIL #8702
800 BIERMANN COURT
SUITE A
MOUNT PROSPECT, IL 60056

Pharmacy Comments

Approval Date

10/14/2022

Contract Begin Date

1/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/19/2022
Agreement registered in error

Covered Entity Signing Official

Lillian Montoya, President and CEO
(505) 913-5258

Contract Pharmacy Representative

Wellpartner
Erica Conner, Account Manager
(972) 654-2778

Signed By Date

10/14/2022