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CAREMARK, L.L.C.
SCH050352-00 BARTON MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
BARTON MEMORIAL HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH050352-00
Entity Address
2170 SOUTH AVENUE
SOUTH LAKE TAHOE, CA 96158
Medicare Provider Number
050352
Participating Start Date
7/1/2023
Last Recertification Date
8/20/2024
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
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kelly Shea Neiger, CFO
(530) 543-5923
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2025
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