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CVS CAREMARK
Sagebrush Health Services
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Covered Entity Details
Entity Name
Sagebrush Health Services
Subdivision Name
Coastal Eye Clinic
Type
Sexually Transmitted Diseases
340B ID
Entity Address
50 Holly Hill Ln
Greenwich, CT 06830
Grant Number
6 NU62PS924521-04-02
Participating Start Date
Last Recertification Date
Pharmacy Details
Pharmacy Name
CVS CAREMARK
Pharmacy Address
DBA CVS/CAREMARK OR CF# 11506
1 GREAT VALLEY BOULEVARD
WILKES BARRE, PA 18706
Pharmacy Comments
Contract Details
Approval Date
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jami Dybik, Vice President
(843) 814-5177
Contract Pharmacy Representative
Signed By Date
7/25/2023
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