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CAREMARK, L.L.C.
CAH331316-00 COMMUNITY MEMORIAL HOSPITAL INC.
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Covered Entity Details
Entity Name
COMMUNITY MEMORIAL HOSPITAL INC.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH331316-00
Entity Address
150 BROAD ST
HAMILTON, NY 13346
Medicare Provider Number
331316
Participating Start Date
4/1/2015
Last Recertification Date
8/15/2024
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
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jason Liebel, Vice President of Finance
(315) 824-6550
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/13/2023
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