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CAREMARK, L.L.C.
STD33484 PolyClinique de West Palm Beach
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Covered Entity Details
Entity Name
PolyClinique de West Palm Beach
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33484
Entity Address
5353 West Atlantic Avenue
Suite 405
Delray Beach, FL 33484
Grant Number
NH25PS005131
Participating Start Date
8/9/2022
Last Recertification Date
5/31/2024
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
11/2/2023
Contract Begin Date
11/3/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Irene Figaro, RN
(561) 276-3000
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
11/2/2023
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