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CAREMARK, L.L.C.
PED443303-00 East Tennessee Children’s Hospital
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Covered Entity Details
Entity Name
East Tennessee Children’s Hospital
Subdivision Name
Type
Children's Hospital
340B ID
PED443303-00
Entity Address
2018 Clinch Avenue
Knoxville, TN 37916
Medicare Provider Number
443303
Participating Start Date
7/1/2017
Last Recertification Date
8/23/2024
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
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Caryn Hawthorne, Chief Financial Officer
(865) 541-8154
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2024
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