Contract Pharmacy Details

CAREMARK, L.L.C.
CH0910370 ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.

Covered Entity Details

Entity Name

ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.

Subdivision Name

St. Johns Well Child and Family Center Magnolia Place

Type

HRSA-Funded Health Center

340B ID

CH0910370

Entity Address

1910 Magnolia Ave
101
Los Angeles, CA 90007

Grant Number

H80CS00873

Participating Start Date

7/1/2003

Last Recertification Date

2/10/2025

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

10/9/2024

Contract Begin Date

1/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

James Mangia, CEO
(323) 541-1600 Ext: 4000

Contract Pharmacy Representative

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

Signed By Date

10/9/2024

340B Drug Pricing Program Database