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CAREMARK, L.L.C.
CAH501317-00 Grant County Public Hospital District #3, dba Columbia Basin Hospital
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Covered Entity Details
Entity Name
Grant County Public Hospital District #3, dba Columbia Basin Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH501317-00
Entity Address
200 Nat Washington Way
Ephrata, WA 98823-1982
Medicare Provider Number
501317
Participating Start Date
7/1/2013
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
10/1/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anthonie Zimmermann, CFO
(732) 552-5812
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/1/2024
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