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CAREMARK, L.L.C.
FQHCLA391 219 HEALTH NETWORK INC
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Covered Entity Details
Entity Name
219 HEALTH NETWORK INC
Subdivision Name
219 Health Network
Type
Health Center Program Look-Alike
340B ID
FQHCLA391
Entity Address
100 W. Chicago Ave. STE F
East Chicago, IN 46312
Grant Number
LALCS32751
Participating Start Date
10/1/2019
Last Recertification Date
2/11/2025
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
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Leo Correa, ADMINISTRATOR-CEO
(219) 392-7004
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2024
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