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CAREMARK, L.L.C.
CH03122Q North Penn Comprehensive Health Services
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Covered Entity Details
Entity Name
North Penn Comprehensive Health Services
Subdivision Name
Troy Laurel Health Center
Type
HRSA-Funded Health Center
340B ID
CH03122Q
Entity Address
45 Mud Creek Rd
Troy, PA 16947-9529
Grant Number
H80CS00682
Participating Start Date
10/1/2021
Last Recertification Date
3/5/2025
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
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ronald M Gilbert, CFO
(570) 828-3869
Contract Pharmacy Representative
Caremark L.L.C.
Christian reid, 340b Program Director
(401) 770-2118
Signed By Date
10/16/2023
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