Contract Pharmacy Details

ADVANCED CARE SCRIPTS, INC
DSH420049 CONWAY HOSPITAL

Covered Entity Details

Entity Name

CONWAY HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH420049

Entity Address

300 SINGLETON RIDGE ROAD
CONWAY, SC 29526

Medicare Provider Number

420049

Participating Start Date

7/1/2019

Last Recertification Date

8/21/2024

Pharmacy Details

Pharmacy Name

ADVANCED CARE SCRIPTS, INC

Pharmacy Address

CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
6251 CHANCELLOR DRIVE
SUITE 101
ORLANDO, FL 32809

Pharmacy Comments

Contract Details

Approval Date

4/2/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Angela Williford, Chief Administrative Officer
(843) 347-8166

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/2/2024

340B Drug Pricing Program Database