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CAREMARK MICHIGAN SPECIALTY PHARMACY, LL
CH090710 COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
Subdivision Name
NIPOMO COMMUNITY MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH090710
Entity Address
150 TEJAS PL
NIPOMO, CA 93444-9123
Grant Number
H80CS00621
Participating Start Date
4/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
CAREMARK MICHIGAN SPECIALTY PHARMACY, LL
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
1307 ALLEN DR STE H
TROY, MI 48083
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
RONALD E. CASTLE, CEO
(805) 459-1835
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/17/2023
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