Contract Pharmacy Details

CAREMARK TENNESSEE SPECIALTY PHARMACY, L
DSH230046 UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS

Covered Entity Details

Entity Name

UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH230046

Entity Address

1500 EAST MEDICAL CENTER DRIVE
ANN ARBOR, MI 48109

Medicare Provider Number

230046

Participating Start Date

1/1/2004

Last Recertification Date

8/20/2024

Pharmacy Details

Pharmacy Name

CAREMARK TENNESSEE SPECIALTY PHARMACY, L

Pharmacy Address

DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
8370 WOLF LAKE DR
STE 107
BARTLETT, TN 38133

Pharmacy Comments

Contract Details

Approval Date

1/12/2016

Contract Begin Date

4/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Tony Denton, COO
(734) 647-6623

Contract Pharmacy Representative

CVS HEALTH
Joan O'Rourke, VP Specialty Program Management
(847) 559-5282

Signed By Date

1/12/2016

340B Drug Pricing Program Database