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CAREMARK MICHIGAN SPECIALTY PHARMACY, LL
FQHCLA407 Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
METRO Clearwater
Type
Health Center Program Look-Alike
340B ID
FQHCLA407
Entity Address
18167 US Highway 19 North
Suite 150
Clearwater, FL 33764-6566
Grant Number
LALCS35348
Participating Start Date
4/14/2020
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
CAREMARK MICHIGAN SPECIALTY PHARMACY, LL
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
1307 ALLEN DR STE H
TROY, MI 48083
Pharmacy Comments
Contract Details
Approval Date
1/5/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
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
1/5/2024
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