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CAREMARK NEW JERSEY SPECIALTY PHCY, LLC
CH032240 PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)
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Covered Entity Details
Entity Name
PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)
Subdivision Name
DBA 48TH STREET PHYSICIANS
Type
HRSA-Funded Health Center
340B ID
CH032240
Entity Address
4714 MARSHALL AVENUE
NEWPORT NEWS, VA 23607-2247
Grant Number
H80CS00073
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
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
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ANGELA FUTRELL, CEO
(757) 591-0643 Ext: 1120
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/13/2023
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