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CAREMARK, L.L.C.
RRC150162-00 FRANCISCAN HEALTH INDIANAPOLIS
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Covered Entity Details
Entity Name
FRANCISCAN HEALTH INDIANAPOLIS
Subdivision Name
Type
Rural Referral Center
340B ID
RRC150162-00
Entity Address
8111 S. EMERSON AVENUE
INDIANAPOLIS, IN 46237
Medicare Provider Number
150162
Participating Start Date
4/26/2021
Last Recertification Date
8/20/2024
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
4/12/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jay Brehm, CFO - Central Indiana
(317) 528-8953
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/12/2023
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