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CAREMARK NEW JERSEY SPECIALTY PHCY, LLC
CH045207HG Cumberland Family Medical Center, Inc.
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Covered Entity Details
Entity Name
Cumberland Family Medical Center, Inc.
Subdivision Name
Warren Central High Healthy Kids Clinic
Type
HRSA-Funded Health Center
340B ID
CH045207HG
Entity Address
559 Morgantown Rd
Bowling Green, KY 42101-3603
Grant Number
H80CS08218
Participating Start Date
4/1/2023
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
CAREMARK NEW JERSEY SPECIALTY PHCY, LLC
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
180 PASSAIC AVE UNIT B-5
FAIRFIELD, NJ 07004
Pharmacy Comments
Contract Details
Approval Date
10/5/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ryan Smith, CFO
(270) 858-6655
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/5/2023
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