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CAREMARK, L.L.C.
DSH040039 ARKANSAS METHODIST MEDICAL CENTER
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Covered Entity Details
Entity Name
ARKANSAS METHODIST MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040039
Entity Address
900 WEST KINGS HIGHWAY
PARAGOULD, AR 72450
Medicare Provider Number
040039
Participating Start Date
1/1/2024
Last Recertification Date
8/19/2024
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
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Staci J Williams, CFO
(870) 239-7105
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2024
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