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CAREMARK, L.L.C.
RWII55404 Rainbow Health Minnesota
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Covered Entity Details
Entity Name
Rainbow Health Minnesota
Subdivision Name
Type
Ryan White Part B
340B ID
RWII55404
Entity Address
701 S 4th Ave
Ste. 1500
Minneapolis, MN 55415
Grant Number
X07HA00028
Participating Start Date
10/1/2022
Last Recertification Date
1/30/2024
Entity Termination Date
4/1/2025
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
12/22/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/31/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jeremy James Hanson Willis, CEO
(612) 373-2400 Ext: 6123065274
Contract Pharmacy Representative
CVS
Alex Hazard, Account Manager
(315) 886-5406
Signed By Date
12/22/2022
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