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CAREMARK KANSAS SPECIALTY PHARMACY
STD33712 Empath Health, Inc.
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Covered Entity Details
Entity Name
Empath Health, Inc.
Subdivision Name
AIDS Service Association of Pinellas dba EPIC
Type
Sexually Transmitted Diseases
340B ID
STD33712
Entity Address
3050 1st Ave S
St. Petersburg, FL 33712
Grant Number
1NU62PS924687-1-00
Participating Start Date
4/1/2018
Last Recertification Date
5/9/2024
Pharmacy Details
Pharmacy Name
CAREMARK KANSAS SPECIALTY PHARMACY
Pharmacy Address
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
11162 RENNER BLVD
LENEXA, KS 66219
Pharmacy Comments
Contract Details
Approval Date
10/31/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Saida Bouhamid, Chief Mission Financial Officer
(727) 523-3339
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/31/2023
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