Contract Pharmacy Details

CAREMARK, L.L.C.
DSH240057 ABBOTT NORTHWESTERN HOSPITAL

Covered Entity Details

Entity Name

ABBOTT NORTHWESTERN HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH240057

Entity Address

800 EAST 28TH STREET
MINNEAPOLIS, MN 55407

Medicare Provider Number

240057

Participating Start Date

10/1/2015

Last Recertification Date

8/13/2024

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

10/9/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Tony M Collins-Kwong, Director, Strategic Sourcing and Services, Pharmacy Services
(612) 262-4785

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/9/2023

340B Drug Pricing Program Database