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CAREMARK KANSAS SPECIALTY PHARMACY
CHC10609-00 UNIVERSITY MUSLIM MEDICAL ASSOCIATION, INC.
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Covered Entity Details
Entity Name
UNIVERSITY MUSLIM MEDICAL ASSOCIATION, INC.
Subdivision Name
UMMA Community Clinic
Type
HRSA-Funded Health Center
340B ID
CHC10609-00
Entity Address
711 W.Florence Ave
Los Angeles, CA 90044-6105
Grant Number
H80CS10609
Participating Start Date
4/1/2006
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
CAREMARK KANSAS SPECIALTY PHARMACY
Pharmacy Address
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
11162 RENNER BLVD
LENEXA, KS 66219
Pharmacy Comments
Contract Details
Approval Date
1/14/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Adel Syed, CEO
(323) 217-7298
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/14/2025
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