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CAREMARK, L.L.C.
DSH390073 ALTOONA REGIONAL HEALTH SYSTEM
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Covered Entity Details
Entity Name
ALTOONA REGIONAL HEALTH SYSTEM
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390073
Entity Address
620 HOWARD AVENUE
ALTOONA, PA 16601-4889
Medicare Provider Number
390073
Participating Start Date
10/1/2018
Last Recertification Date
9/4/2024
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
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Monica J Klatt, Chief Financial Officer
(814) 889-2223
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/16/2024
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