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CAREMARK ILLINOIS SPECIALTY PHARMACY, LL
CH011190 OUTER CAPE HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
OUTER CAPE HEALTH SERVICES, INC.
Subdivision Name
PROVINCETOWN HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH011190
Entity Address
49 Harry Kemp Way
Provincetown, MA 02657-1618
Grant Number
H80CS00468
Participating Start Date
4/1/2002
Last Recertification Date
2/12/2025
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
7/7/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Patricia Nadle, CEO
(508) 905-2800
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/7/2023
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