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CAREMARK ILLINOIS SPECIALTY PHARMACY, LL
DSH050108 SUTTER VALLEY HOSPITALS DBA SUTTER MEDICAL CENTER SACRAMENTO
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Covered Entity Details
Entity Name
SUTTER VALLEY HOSPITALS DBA SUTTER MEDICAL CENTER SACRAMENTO
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050108
Entity Address
2825 Capitol Avenue
SACRAMENTO, CA 95816
Medicare Provider Number
050108
Participating Start Date
4/1/2006
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
CAREMARK ILLINOIS SPECIALTY PHARMACY, LL
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
800 BIERMANN CT STE B
MOUNT PROSPECT, IL 60056
Pharmacy Comments
Contract Details
Approval Date
10/19/2022
Contract Begin Date
11/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Timothy J. Noakes, CFO
(916) 887-4500
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/19/2022
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