Contract Pharmacy Details

CAREMARK, L.L.C.
RRC240047-00 ST. LUKES HOSPITAL OF DULUTH

Covered Entity Details

Entity Name

ST. LUKES HOSPITAL OF DULUTH

Subdivision Name

Type

Rural Referral Center

340B ID

RRC240047-00

Entity Address

915 EAST FIRST STREET
DULUTH, MN 55805

Medicare Provider Number

240047

Participating Start Date

1/1/2025

Last Recertification Date

Entity Termination Date

1/1/2025

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

10/22/2024

Contract Begin Date

1/1/2025

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Michael Boeselager, Vice President Support Services
(218) 249-2459

Contract Pharmacy Representative

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

Signed By Date

10/15/2024

340B Drug Pricing Program Database