Contract Pharmacy Details

CAREMARK, L.L.C.
FQHCLA407M Metropolitan Charities, Inc.

Covered Entity Details

Entity Name

Metropolitan Charities, Inc.

Subdivision Name

METRO South St. Pete

Type

Health Center Program Look-Alike

340B ID

FQHCLA407M

Entity Address

2116 34th St S
Saint Petersburg, FL 33711-3224

Grant Number

LALCS35348

Participating Start Date

12/21/2023

Last Recertification Date

2/21/2025

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

12/28/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2024
Agreement registered in error

Contacts

Covered Entity Signing Official

Priya Rajkumar, Chief Executive Officer
(727) 321-3854 Ext: 1230

Contract Pharmacy Representative

CVS
Walter Jury, Account Manager
(315) 271-5312

Signed By Date

12/28/2023

340B Drug Pricing Program Database