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CAREMARK KANSAS SPECIALTY PHARMACY
CH043270 EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Subdivision Name
EAU CLAIRE COOPERATIVE HEALTH CENTER ADMINISTRATIVE OFFICES
Type
HRSA-Funded Health Center
340B ID
CH043270
Entity Address
221 Dawson Road
COLUMBIA, SC 29223
Grant Number
H80CS00730
Participating Start Date
4/1/2002
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
CAREMARK KANSAS SPECIALTY PHARMACY
Pharmacy Address
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
11162 RENNER BLVD
LENEXA, KS 66219
Pharmacy Comments
Contract Details
Approval Date
7/5/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DELGADO CANTAVE, CEO
(803) 733-5969 Ext: 4146
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/5/2024
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